| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $95 | $116 | $137 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $115 | $140 | $166 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $38 | $40 | $45 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $63 | $98 | $133 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $27 | $35 | $44 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $42 | $53 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $51 | $51 | $51 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $95 | $95 | $95 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $106 | $106 | $106 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $66 | $66 | $66 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $119 | $168 | $216 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $147 | $147 | $147 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $162 | $238 | $276 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $127 | $127 | $127 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $67 | $67 | $67 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $53 | $53 | $53 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $4 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $119 | $143 | $168 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $46 | $84 | $122 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $38 | $90 | $145 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $51 | $86 | $120 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $133 | $153 | $173 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $15 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $13 | $43 | $67 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $35 | $48 | $61 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $76 | $267 | $457 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $69 | $121 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $27 | $43 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $105 | $327 | $549 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $932 | $3,049 | $5,165 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $34 | $85 | $136 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $205 | $1,481 | $2,185 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $194 | $203 | $212 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $593 | $593 | $593 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $359 | $377 | $394 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $167 | $177 | $183 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $38 | $220 | $315 |
| Septoplasty CPT 30520 • ENT | $447 | $576 | $705 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $160 | $160 | $160 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $138 | $180 | $222 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $243 | $264 | $284 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $219 | $339 | $460 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $323 | $344 | $365 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $38 | $78 | $158 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $255 | $255 | $255 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $408 | $408 | $408 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $38 | $84 | $130 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $211 | $267 | $324 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $220 | $220 | $220 |