| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $49 | $82 | $115 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $142 | $144 | $147 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $41 | $88 | $106 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $100 | $110 | $118 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $102 | $102 | $102 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $112 | $112 | $112 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $78 | $79 | $80 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $66 | $84 | $102 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $119 | $165 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $132 | $134 | $135 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $119 | $150 | $182 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $139 | $142 | $146 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $226 | $241 | $257 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $118 | $157 | $197 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $106 | $107 | $107 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $57 | $60 | $63 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $5 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $153 | $153 | $153 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $95 | $102 | $108 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $112 | $124 | $137 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $109 | $109 | $110 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $66 | $108 | $150 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $4 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $8 | $41 | $62 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $33 | $35 | $38 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $187 | $324 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $45 | $111 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $5 | $5 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $60 | $250 | $627 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $2,814 | $5,055 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $97 | $174 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $216 | $1,078 | $2,744 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $213 | $216 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $823 | $823 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $403 | $429 | $456 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $168 | $184 | $195 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $276 | $321 | $409 |
| Septoplasty CPT 30520 • ENT | $631 | $633 | $635 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $140 | $140 | $141 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $133 | $164 | $186 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $157 | $242 | $329 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $409 | $409 | $410 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $309 | $316 | $322 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $179 | $226 | $249 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $48 | $156 | $263 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $376 | $376 | $376 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $39 | $162 | $262 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $284 | $321 | $357 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $297 | $297 | $297 |