| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $126 | $150 | $169 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $155 | $217 | $279 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $67 | $94 | $109 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $53 | $92 | $163 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $107 | $109 | $111 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $51 | $107 | $156 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $127 | $153 | $169 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $55 | $131 | $206 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $118 | $160 | $225 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $118 | $118 | $118 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $101 | $101 | $101 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $295 | $295 | $295 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $167 | $220 | $245 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $150 | $150 | $150 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $55 | $100 | $144 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $55 | $67 | $73 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $8 | $25 | $55 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $124 | $166 | $209 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $111 | $146 | $177 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $87 | $110 | $133 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $110 | $110 | $110 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $174 | $174 | $174 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $49 | $49 | $49 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $16 | $16 | $16 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $366 | $366 | $366 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $77 | $77 | $77 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $14 | $14 | $14 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $60 | $60 | $60 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $529 | $529 | $529 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $127 | $127 | $127 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,401 | $1,401 | $1,401 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $323 | $323 | $323 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $989 | $989 | $989 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $479 | $479 | $479 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $222 | $222 | $222 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $191 | $396 | $690 |
| Septoplasty CPT 30520 • ENT | $707 | $830 | $953 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $209 | $209 | $209 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $179 | $185 | $191 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $265 | $397 | $528 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $457 | $515 | $572 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $350 | $507 | $665 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $192 | $200 | $216 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $55 | $180 | $305 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $407 | $623 | $838 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $55 | $144 | $202 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $271 | $293 | $315 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $55 | $214 | $373 |