| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $88 | $129 | $180 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $144 | $181 | $217 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $47 | $60 | $69 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $61 | $76 | $84 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $144 | $144 | $144 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $80 | $88 | $97 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $131 | $137 | $144 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $48 | $115 | $169 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $153 | $233 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $192 | $192 | $192 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $167 | $191 | $215 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $314 | $314 | $314 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $222 | $338 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $111 | $166 | $222 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $41 | $83 | $151 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $49 | $69 | $89 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $5 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $118 | $126 | $133 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $44 | $86 | $119 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $128 | $180 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $73 | $117 | $160 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $180 | $201 | $223 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $27 | $29 | $31 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $7 | $8 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $40 | $66 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $39 | $57 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $119 | $417 | $714 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $67 | $160 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $14 | $59 | $126 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $79 | $378 | $974 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $730 | $4,710 | $8,690 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $25 | $129 | $232 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $409 | $1,757 | $3,056 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $278 | $295 | $313 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $808 | $862 | $916 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $446 | $475 | $504 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $184 | $218 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $388 | $395 | $398 |
| Septoplasty CPT 30520 • ENT | $559 | $625 | $692 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $32 | $166 | $299 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $175 | $220 | $265 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $238 | $268 | $297 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $249 | $413 | $576 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $365 | $453 | $541 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $181 | $209 | $265 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $48 | $238 | $427 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $32 | $357 | $682 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $203 | $211 | $220 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $310 | $352 | $394 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $411 | $411 | $411 |