| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $66 | $120 | $175 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $80 | $148 | $216 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $122 | $126 | $132 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $131 | $147 | $163 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $134 | $134 | $134 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $49 | $56 | $64 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $113 | $140 | $168 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $202 | $202 | $202 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $149 | $152 | $154 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $141 | $147 | $154 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $162 | $187 | $212 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $160 | $235 | $309 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $221 | $284 | $334 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $170 | $170 | $170 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $134 | $143 | $153 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $58 | $67 | $76 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $4 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $176 | $176 | $176 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $151 | $153 | $155 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $117 | $152 | $182 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $82 | $99 | $116 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $157 | $166 | $175 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $13 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $34 | $46 | $60 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $41 | $54 | $67 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $79 | $351 | $623 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $79 | $141 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $35 | $60 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $106 | $419 | $732 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $961 | $3,667 | $6,373 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $30 | $126 | $222 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,058 | $2,238 | $2,402 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $196 | $202 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $774 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $403 | $427 | $452 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $177 | $184 | $188 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $355 | $478 | $608 |
| Septoplasty CPT 30520 • ENT | $814 | $835 | $856 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $191 | $288 | $386 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $224 | $256 | $288 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $246 | $277 | $307 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $371 | $448 | $525 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $390 | $466 | $543 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $55 | $126 | $269 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $431 | $431 | $431 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $667 | $676 | $684 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $266 | $284 | $302 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $346 | $373 | $400 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $416 | $416 | $416 |