| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $62 | $107 | $155 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $127 | $184 | $236 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $40 | $144 | $226 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $102 | $142 | $203 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $43 | $105 | $168 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $106 | $149 | $193 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $158 | $188 | $209 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $65 | $170 | $252 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $71 | $223 | $384 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $227 | $227 | $227 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $163 | $205 | $247 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $493 | $493 | $493 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $102 | $356 | $576 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $260 | $260 | $260 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $64 | $107 | $178 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $64 | $87 | $113 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $32 | $64 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $225 | $267 | $309 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $85 | $114 | $186 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $111 | $232 | $304 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $56 | $74 | $92 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $123 | $173 | $222 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $15 | $24 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $47 | $86 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $27 | $45 | $63 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $139 | $202 | $265 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $31 | $66 | $100 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $21 | $32 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $187 | $299 | $412 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $953 | $2,474 | $3,994 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $53 | $97 | $140 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,586 | $1,803 | $2,235 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $174 | $260 | $345 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $774 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $591 | $675 | $749 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $157 | $163 | $176 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $112 | $453 | $741 |
| Septoplasty CPT 30520 • ENT | $540 | $715 | $825 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $45 | $173 | $302 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $69 | $175 | $351 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $223 | $430 | $571 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $243 | $305 | $368 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $356 | $498 | $691 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $266 | $400 | $467 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $45 | $390 | $718 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $681 | $776 | $871 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $168 | $307 | $444 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $269 | $380 | $500 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $521 | $603 | $684 |