| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $169 | $192 | $215 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $209 | $209 | $209 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $67 | $101 | $136 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $163 | $164 | $164 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $142 | $142 | $142 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $62 | $109 | $156 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $166 | $169 | $172 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $143 | $173 | $202 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $114 | $173 | $231 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $193 | $193 | $193 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $266 | $266 | $266 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $308 | $308 | $308 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $167 | $248 | $330 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $273 | $273 | $273 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $155 | $155 | $155 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $88 | $89 | $90 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $8 | $9 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $134 | $172 | $209 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $150 | $151 | $152 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $87 | $132 | $178 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $155 | $155 | $155 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $87 | $87 | $87 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $3 | $3 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $1 | $1 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $41 | $41 | $41 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $4 | $4 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $38 | $38 | $38 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $10 | $10 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $4 | $4 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $50 | $50 | $50 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $440 | $440 | $440 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $15 | $15 | $15 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,104 | $1,104 | $1,104 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $160 | $160 | $160 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $419 | $419 | $419 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $348 | $348 | $348 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $145 | $145 | $145 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $402 | $402 | $402 |
| Septoplasty CPT 30520 • ENT | $920 | $920 | $920 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $295 | $295 | $295 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $253 | $253 | $253 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $347 | $347 | $347 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $331 | $331 | $331 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $441 | $441 | $441 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $245 | $245 | $245 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $362 | $362 | $362 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $515 | $515 | $515 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $261 | $261 | $261 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $398 | $398 | $398 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $417 | $417 | $417 |