| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $156 | $179 | $203 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $189 | $189 | $189 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $66 | $171 | $276 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $53 | $61 | $70 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $117 | $142 | $167 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $46 | $56 | $66 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $137 | $245 | $354 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $148 | $162 | $176 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $115 | $155 | $195 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $127 | $132 | $137 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $552 | $552 | $552 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $221 | $221 | $221 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $412 | $448 | $485 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $195 | $195 | $195 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $104 | $142 | $179 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $66 | $129 | $192 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $6 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $169 | $301 | $433 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $180 | $248 | $315 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $125 | $170 | $215 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $199 | $199 | $199 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $179 | $179 | $179 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $23 | $23 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $6 | $6 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $33 | $33 | $33 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $8 | $8 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $84 | $84 | $84 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $16 | $16 | $16 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $8 | $8 | $8 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $84 | $84 | $84 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,030 | $1,030 | $1,030 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $25 | $25 | $25 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,895 | $1,895 | $1,895 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $216 | $216 | $216 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $774 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $392 | $392 | $392 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $163 | $163 | $163 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $448 | $495 | $541 |
| Septoplasty CPT 30520 • ENT | $1,059 | $1,444 | $1,828 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $232 | $232 | $232 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $195 | $261 | $327 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $355 | $390 | $425 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $320 | $505 | $690 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $1,205 | $1,205 | $1,205 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $232 | $272 | $311 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $66 | $220 | $375 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $657 | $1,090 | $1,523 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $316 | $438 | $560 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $320 | $407 | $493 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $337 | $424 | $512 |