| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $260 | $281 | $301 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $365 | $365 | $365 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $197 | $210 | $237 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $292 | $292 | $292 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $44 | $44 | $44 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $142 | $142 | $142 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $158 | $161 | $165 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $305 | $337 | $369 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $238 | $324 | $410 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $131 | $173 | $216 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $474 | $474 | $474 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $279 | $279 | $279 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $606 | $606 | $606 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $492 | $492 | $492 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $140 | $173 | $206 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $83 | $83 | $83 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $8 | $8 | $8 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $246 | $246 | $246 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $140 | $182 | $224 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $318 | $318 | $318 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $245 | $245 | $245 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $175 | $175 | $175 |
| 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 | $40 | $40 | $40 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $35 | $35 | $35 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $232 | $232 | $232 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $90 | $90 | $90 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $8 | $8 | $8 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $402 | $402 | $402 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $315 | $315 | $315 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $10 | $10 | $10 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $124 | $124 | $124 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $211 | $211 | $211 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $306 | $306 | $306 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $357 | $357 | $357 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $144 | $144 | $144 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $682 | $798 | $988 |
| Septoplasty CPT 30520 • ENT | $1,553 | $1,605 | $1,658 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $342 | $439 | $536 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $161 | $310 | $458 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $199 | $411 | $623 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $300 | $688 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $399 | $594 | $790 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $437 | $444 | $450 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $328 | $487 | $646 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $466 | $693 | $921 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $231 | $350 | $469 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $348 | $528 | $709 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $740 | $743 | $745 |