| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $53 | $111 | $157 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $152 | $154 | $156 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $77 | $101 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $90 | $154 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $68 | $107 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $37 | $50 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $58 | $86 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $70 | $110 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $121 | $149 | $177 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $87 | $143 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $142 | $203 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $158 | $158 | $158 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $175 | $259 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $30 | $120 | $210 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $105 | $172 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $49 | $68 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $18 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $94 | $158 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $84 | $114 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $128 | $148 | $200 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $112 | $114 | $117 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $152 | $161 | $171 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $6 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $39 | $55 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $30 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $61 | $290 | $518 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $96 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $47 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $81 | $367 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $722 | $764 | $807 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $188 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $268 | $2,117 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $288 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $815 | $915 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $452 | $683 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $188 | $285 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $204 | $291 |
| Septoplasty CPT 30520 • ENT | $663 | $664 | $665 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $150 | $190 | $231 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $127 | $208 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $246 | $439 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $431 | $432 | $433 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $231 | $346 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $181 | $192 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $192 | $284 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $210 | $405 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $86 | $143 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $257 | $407 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $258 | $425 |