| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $54 | $89 | $123 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $119 | $141 | $153 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $70 | $107 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $92 | $126 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $127 | $223 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $80 | $113 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $109 | $177 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $180 | $329 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $175 | $248 | $322 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $166 | $302 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $142 | $203 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $160 | $160 | $160 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $202 | $340 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $266 | $266 | $266 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $115 | $211 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $66 | $115 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $16 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $100 | $163 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $108 | $178 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $128 | $189 | $279 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $74 | $99 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $137 | $145 | $152 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $6 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $50 | $65 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $29 | $41 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $38 | $364 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $94 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $52 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $50 | $635 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $440 | $623 | $807 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $27 | $109 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,280 | $2,544 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $201 | $284 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $419 | $717 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $348 | $574 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $145 | $270 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $378 | $725 |
| Septoplasty CPT 30520 • ENT | $1,438 | $1,548 | $1,658 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $215 | $339 | $463 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $237 | $458 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $332 | $623 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $515 | $795 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $419 | $790 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $189 | $216 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $341 | $646 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $290 | $550 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $219 | $409 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $352 | $709 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $366 | $740 |