| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $54 | $80 | $123 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $152 | $154 | $159 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $52 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $71 | $126 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $67 | $104 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $42 | $51 |
| 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 | $101 | $157 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $175 | $175 | $175 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $93 | $139 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $88 | $203 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $160 | $160 | $160 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $106 | $261 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $211 | $211 | $211 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $68 | $105 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $52 | $70 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $10 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $94 | $158 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $82 | $116 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $102 | $138 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $74 | $99 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $72 | $112 | $152 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $14 | $19 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $52 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $53 | $57 | $61 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $81 | $385 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $70 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $54 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $60 | $506 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $985 | $4,528 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $27 | $109 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $346 | $2,143 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $201 | $284 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $786 | $901 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $435 | $617 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $181 | $283 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $160 | $468 |
| Septoplasty CPT 30520 • ENT | $30 | $492 | $780 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $146 | $148 | $150 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $131 | $244 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $202 | $470 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $30 | $164 | $298 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $226 | $436 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $189 | $216 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $181 | $347 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $290 | $550 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $134 | $205 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $184 | $361 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $179 | $329 |