| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $200 | $259 | $319 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $144 | $144 | $144 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $150 | $203 | $257 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $131 | $131 | $131 |
| 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 | $117 | $117 | $117 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $324 | $324 | $324 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $250 | $323 | $397 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $139 | $287 | $436 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $364 | $364 | $364 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $310 | $310 | $310 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $377 | $377 | $377 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $410 | $410 | $410 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $516 | $516 | $516 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $138 | $138 | $138 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $111 | $141 | $170 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $9 | $13 | $17 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $252 | $252 | $252 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $185 | $236 | $287 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $202 | $205 | $209 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $322 | $322 | $322 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $179 | $179 | $179 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $6 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $70 | $83 | $96 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $37 | $77 | $117 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $66 | $66 | $66 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $17 | $17 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $7 | $7 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $88 | $88 | $88 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $769 | $769 | $769 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $26 | $26 | $26 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,932 | $1,932 | $1,932 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $280 | $280 | $280 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $733 | $733 | $733 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $608 | $608 | $608 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $254 | $254 | $254 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $216 | $536 | $936 |
| Septoplasty CPT 30520 • ENT | $530 | $1,335 | $2,141 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $689 | $689 | $689 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $204 | $278 | $352 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $658 | $733 | $808 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $1,382 | $1,382 | $1,382 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $778 | $898 | $1,019 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $218 | $342 | $567 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $836 | $836 | $836 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $1,190 | $1,190 | $1,190 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $308 | $417 | $618 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $504 | $721 | $938 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $982 | $982 | $982 |