| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $123 | $131 | $139 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $153 | $286 | $420 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $35 | $96 | $275 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $100 | $218 | $336 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $113 | $113 | $113 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $44 | $182 | $320 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $188 | $347 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $66 | $221 | $424 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $188 | $321 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $386 | $386 | $386 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $546 | $546 | $546 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $418 | $418 | $418 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $686 | $686 | $686 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $561 | $561 | $561 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $80 | $119 | $158 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $56 | $98 | $181 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $5 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $182 | $310 | $438 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $81 | $169 | $307 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $112 | $171 | $230 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $313 | $313 | $313 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $450 | $450 | $450 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $3 | $3 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $1 | $1 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $36 | $36 | $36 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $3 | $3 | $3 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $33 | $33 | $33 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $11 | $13 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $4 | $4 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $42 | $51 | $60 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $382 | $382 | $382 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $13 | $13 | $13 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $959 | $959 | $959 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $140 | $140 | $140 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $548 | $548 | $548 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $304 | $304 | $304 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $127 | $127 | $127 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $789 | $789 | $789 |
| Septoplasty CPT 30520 • ENT | $1,802 | $1,802 | $1,802 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $597 | $597 | $597 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $165 | $192 | $230 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $329 | $517 | $704 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $692 | $692 | $692 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $922 | $922 | $922 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $512 | $512 | $512 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $754 | $754 | $754 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $1,077 | $1,077 | $1,077 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $531 | $531 | $531 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $814 | $814 | $814 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $849 | $849 | $849 |