| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $60 | $94 | $128 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $155 | $179 | $202 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $70 | $118 | $214 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $95 | $126 | $158 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $161 | $161 | $161 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $56 | $64 | $72 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $110 | $161 | $213 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $102 | $114 | $126 |
| 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 | $138 | $158 | $178 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $189 | $306 | $423 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $298 | $298 | $298 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $203 | $222 | $252 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $199 | $232 | $265 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $92 | $103 | $113 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $100 | $100 | $100 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $9 | $9 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $358 | $358 | $358 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $90 | $101 | $112 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $107 | $130 | $149 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $77 | $116 | $154 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $68 | $132 | $197 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $7 | $10 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $2 | $4 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $6 | $24 | $36 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $35 | $40 | $45 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $512 | $606 | $700 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $82 | $112 | $143 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $2 | $34 | $66 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $76 | $83 | $89 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $2,724 | $4,924 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $21 | $59 | $97 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $310 | $1,810 | $2,561 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $134 | $171 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $543 | $587 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $220 | $236 | $268 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $108 | $182 | $330 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $379 | $452 | $488 |
| Septoplasty CPT 30520 • ENT | $697 | $791 | $884 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $151 | $165 | $178 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $212 | $261 | $309 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $263 | $315 | $366 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $320 | $333 | $346 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $469 | $576 | $684 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $231 | $253 | $295 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $343 | $357 | $372 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $586 | $586 | $586 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $197 | $201 | $206 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $392 | $439 | $486 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $249 | $287 | $326 |