| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $62 | $106 | $134 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $143 | $155 | $167 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $101 | $106 | $109 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $115 | $123 | $131 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $38 | $38 | $38 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $44 | $47 | $49 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $119 | $128 | $137 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $65 | $108 | $144 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $71 | $121 | $171 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $132 | $143 | $154 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $123 | $168 | $212 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $154 | $157 | $160 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $152 | $234 | $264 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $208 | $213 | $218 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $35 | $91 | $134 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $56 | $66 | $84 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $4 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $93 | $137 | $181 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $72 | $103 | $121 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $78 | $121 | $142 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $109 | $112 | $116 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $153 | $155 | $157 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $13 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $8 | $42 | $60 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $41 | $50 | $59 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $292 | $545 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $79 | $141 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $6 | $8 | $10 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $73 | $90 | $106 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $437 | $3,405 | $6,373 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $33 | $100 | $167 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $173 | $938 | $2,402 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $174 | $191 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $525 | $525 | $525 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $285 | $368 | $452 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $177 | $184 | $188 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $167 | $336 | $465 |
| Septoplasty CPT 30520 • ENT | $612 | $735 | $814 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $146 | $203 | $260 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $69 | $171 | $224 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $299 | $316 | $341 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $398 | $462 | $525 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $309 | $369 | $407 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $205 | $213 | $217 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $167 | $210 | $253 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $361 | $408 | $455 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $34 | $127 | $168 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $305 | $337 | $361 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $286 | $325 | $363 |