| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $121 | $161 | $201 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $147 | $182 | $245 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $41 | $79 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $100 | $132 | $193 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $39 | $72 | $105 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $44 | $68 | $114 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $81 | $109 | $125 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $66 | $130 | $153 |
| 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 | $101 | $120 | $140 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $191 | $272 | $312 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $146 | $184 | $223 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $192 | $272 | $384 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $123 | $222 | $320 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $55 | $105 | $181 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $57 | $62 | $65 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $6 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $94 | $124 | $153 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $105 | $124 | $175 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $103 | $137 | $205 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $110 | $240 | $371 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $157 | $204 | $251 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $10 | $15 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $39 | $102 | $205 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $12 | $70 | $171 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $41 | $62 | $96 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $26 | $54 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $26 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $388 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $1,561 | $2,548 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $16 | $24 | $37 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $216 | $1,065 | $2,708 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $572 | $934 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $823 | $2,242 | $3,661 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $411 | $433 | $456 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $171 | $402 | $845 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $276 | $343 | $461 |
| Septoplasty CPT 30520 • ENT | $631 | $839 | $1,047 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $140 | $275 | $411 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $62 | $171 | $303 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $157 | $284 | $398 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $410 | $421 | $432 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $317 | $524 | $933 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $165 | $169 | $179 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $259 | $261 | $263 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $376 | $376 | $376 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $174 | $265 | $435 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $284 | $340 | $451 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $297 | $297 | $297 |