| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $46 | $67 | $88 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $56 | $56 | $56 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $25 | $47 | $69 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $65 | $74 | $84 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $51 | $51 | $51 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $36 | $58 | $80 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $93 | $93 | $93 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $76 | $102 | $129 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $99 | $124 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $107 | $107 | $107 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $130 | $130 | $130 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $102 | $102 | $102 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $131 | $158 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $132 | $132 | $132 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $74 | $85 | $96 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $38 | $43 | $49 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $7 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $118 | $144 | $170 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $74 | $78 | $81 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $58 | $76 | $94 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $32 | $32 | $32 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $119 | $119 | $119 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $23 | $23 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $8 | $8 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $39 | $39 | $39 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $73 | $74 | $74 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $98 | $98 | $98 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $18 | $21 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $25 | $38 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $79 | $110 | $140 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,202 | $1,202 | $1,202 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $33 | $33 | $33 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,764 | $2,764 | $2,764 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $197 | $197 | $197 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $904 | $904 | $904 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $427 | $427 | $427 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $178 | $232 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $319 | $319 | $319 |
| Septoplasty CPT 30520 • ENT | $414 | $414 | $414 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $169 | $169 | $169 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $146 | $146 | $146 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $167 | $167 | $167 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $258 | $258 | $258 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $382 | $382 | $382 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $186 | $186 | $186 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $301 | $301 | $301 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $483 | $483 | $483 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $142 | $142 | $142 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $243 | $243 | $243 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $264 | $264 | $264 |