| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $175 | $224 | $283 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $103 | $223 | $342 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $67 | $109 | $150 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $125 | $226 | $434 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $54 | $58 | $62 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $57 | $145 | $195 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $148 | $162 | $169 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $133 | $170 | $206 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $203 | $214 | $225 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $96 | $131 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $152 | $426 | $699 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $196 | $196 | $196 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $213 | $402 | $902 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $260 | $362 | $463 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $87 | $110 | $152 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $66 | $89 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $8 | $16 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $209 | $216 | $224 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $75 | $191 | $401 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $87 | $232 | $476 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $85 | $96 | $107 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $91 | $118 | $145 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $14 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $47 | $60 | $67 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $49 | $53 | $58 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $60 | $68 | $76 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $22 | $90 | $158 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $6 | $9 | $11 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $140 | $495 | $851 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,202 | $4,038 | $6,875 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $24 | $28 | $33 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,185 | $2,559 | $2,746 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $190 | $229 | $269 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $481 | $692 | $904 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $328 | $393 | $458 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $152 | $177 | $191 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $216 | $704 | $1,619 |
| Septoplasty CPT 30520 • ENT | $537 | $1,210 | $2,303 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $281 | $392 | $502 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $112 | $374 | $766 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $271 | $549 | $954 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $373 | $700 | $1,026 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $425 | $830 | $1,506 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $218 | $396 | $534 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $350 | $416 | $483 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $370 | $520 | $692 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $241 | $275 | $308 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $389 | $635 | $1,096 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $406 | $456 | $522 |