| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $95 | $116 | $137 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $46 | $122 | $166 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $64 | $108 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $78 | $133 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $42 | $53 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $32 | $34 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $61 | $92 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $71 | $113 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $126 | $126 | $126 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $66 | $102 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $130 | $216 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $175 | $175 | $175 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $191 | $241 | $276 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $96 | $96 | $96 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $52 | $74 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $46 | $63 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $18 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $83 | $135 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $79 | $122 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $102 | $129 | $145 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $56 | $96 | $120 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $137 | $155 | $173 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $15 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $10 | $44 | $67 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $35 | $42 | $49 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $69 | $73 | $76 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $69 | $121 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $54 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $104 | $527 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $931 | $3,048 | $5,165 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $34 | $191 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,183 | $2,400 | $2,736 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $193 | $203 | $212 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $593 | $593 | $593 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $359 | $579 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $15 | $121 | $182 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $227 | $343 |
| Septoplasty CPT 30520 • ENT | $484 | $594 | $705 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $37 | $72 | $106 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $134 | $222 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $190 | $284 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $218 | $339 | $460 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $238 | $365 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $157 | $194 | $212 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $141 | $253 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $286 | $427 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $109 | $172 | $236 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $195 | $324 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $135 | $241 |