| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $132 | $215 | $299 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $145 | $154 | $164 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $85 | $100 | $108 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $128 | $209 | $289 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $97 | $97 | $97 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $114 | $119 | $123 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $196 | $196 | $196 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $365 | $365 | $365 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $405 | $405 | $405 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $248 | $248 | $248 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $207 | $339 | $470 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $548 | $548 | $548 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $255 | $367 | $590 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $128 | $306 | $484 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $265 | $265 | $265 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $129 | $129 | $129 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $8 | $14 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $377 | $377 | $377 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $120 | $192 | $265 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $139 | $159 | $198 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $122 | $194 | $266 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $156 | $268 | $380 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $35 | $56 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $22 | $39 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $281 | $512 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $78 | $143 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $23 | $40 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $479 | $896 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $3,569 | $6,565 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $126 | $232 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $215 | $1,056 | $2,736 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $175 | $192 | $210 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $823 | $823 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $33 | $244 | $456 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $15 | $119 | $190 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $32 | $397 | $725 |
| Septoplasty CPT 30520 • ENT | $1,552 | $1,605 | $1,658 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $515 | $525 | $536 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $458 | $458 | $458 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $386 | $504 | $623 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $594 | $835 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $790 | $791 | $793 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $212 | $288 | $440 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $646 | $647 | $648 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $925 | $925 | $925 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $236 | $347 | $458 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $700 | $704 | $709 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $730 | $730 | $730 |