| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $122 | $156 | $190 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $122 | $178 | $235 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $149 | $227 | $382 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $169 | $177 | $185 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $388 | $388 | $388 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $232 | $232 | $232 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $122 | $122 | $122 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $212 | $212 | $212 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $174 | $174 | $174 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $136 | $136 | $136 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $299 | $347 | $395 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $321 | $321 | $321 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $371 | $372 | $374 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $408 | $408 | $408 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $79 | $149 | $219 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $82 | $87 | $91 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $9 | $9 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $200 | $200 | $200 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $109 | $140 | $172 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $128 | $177 | $202 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $157 | $313 | $469 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $212 | $261 | $311 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $8 | $10 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $26 | $73 | $117 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $21 | $45 | $68 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $90 | $185 | $280 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $82 | $160 | $239 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $2 | $51 | $100 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $122 | $197 | $273 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $378 | $5,342 | $10,307 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $10 | $23 | $36 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $403 | $1,543 | $3,720 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $143 | $204 | $264 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $154 | $154 | $154 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $233 | $336 | $438 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $128 | $202 | $241 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $428 | $433 | $436 |
| Septoplasty CPT 30520 • ENT | $632 | $816 | $999 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $1,285 | $1,285 | $1,285 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $276 | $734 | $1,192 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $156 | $266 | $376 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $635 | $640 | $645 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $472 | $484 | $496 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $267 | $270 | $275 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $261 | $261 | $261 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $552 | $651 | $750 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $187 | $253 | $319 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $492 | $1,147 | $1,803 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $639 | $639 | $639 |