| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $168 | $217 | $269 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $79 | $247 | $335 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $67 | $88 | $142 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $105 | $163 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $148 | $148 | $148 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $156 | $225 | $295 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $73 | $119 | $166 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $144 | $175 | $206 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $225 | $231 | $238 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $92 | $92 | $92 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $38 | $73 | $107 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $202 | $202 | $202 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $38 | $127 | $278 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $285 | $285 | $285 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $94 | $94 | $94 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $61 | $66 | $72 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $16 | $38 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $137 | $173 | $209 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $59 | $104 | $150 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $38 | $93 | $138 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $132 | $132 | $132 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $182 | $182 | $182 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $10 | $30 | $50 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $4 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $22 | $35 | $54 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $22 | $39 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $51 | $131 | $212 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $78 | $143 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $30 | $56 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $478 | $896 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $3,098 | $5,672 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $13 | $16 | $18 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,385 | $1,791 | $1,995 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $208 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $734 | $734 | $734 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $41 | $191 | $342 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $169 | $186 | $203 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $32 | $107 | $250 |
| Septoplasty CPT 30520 • ENT | $38 | $1,031 | $2,024 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $192 | $192 | $192 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $38 | $103 | $168 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $38 | $285 | $532 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $38 | $182 | $327 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $38 | $173 | $307 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $192 | $345 | $651 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $233 | $233 | $233 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $333 | $409 | $484 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $101 | $111 | $120 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $38 | $146 | $255 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $405 | $405 | $405 |