| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $62 | $89 | $116 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $57 | $119 | $181 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $33 | $46 | $68 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $56 | $73 | $90 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $32 | $50 | $68 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $38 | $67 | $83 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $112 | $118 | $124 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $92 | $112 | $143 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $110 | $114 | $118 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $92 | $121 | $143 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $103 | $143 | $183 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $145 | $172 | $199 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $41 | $115 | $159 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $41 | $115 | $193 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $41 | $78 | $99 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $41 | $55 | $69 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $6 | $12 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $167 | $182 | $198 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $99 | $103 | $108 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $77 | $95 | $127 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $39 | $55 | $70 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $70 | $120 | $170 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $10 | $14 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $4 | $5 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $32 | $33 | $33 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $44 | $48 | $57 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $51 | $214 | $512 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $101 | $143 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $41 | $56 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $89 | $364 | $896 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $810 | $4,491 | $6,331 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $30 | $165 | $232 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $222 | $1,644 | $2,226 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $193 | $193 | $193 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $593 | $692 | $791 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $41 | $179 | $316 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $41 | $98 | $156 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $41 | $301 | $435 |
| Septoplasty CPT 30520 • ENT | $553 | $583 | $612 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $133 | $180 | $227 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $90 | $140 | $191 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $223 | $273 | $323 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $270 | $307 | $344 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $395 | $453 | $510 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $41 | $131 | $248 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $41 | $252 | $402 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $462 | $535 | $644 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $41 | $128 | $190 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $289 | $307 | $325 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $292 | $315 | $352 |