| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $90 | $107 | $123 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $109 | $138 | $153 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $40 | $80 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $53 | $97 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $24 | $64 | $105 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $44 | $69 | $114 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $70 | $97 | $125 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $85 | $119 | $153 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $95 | $95 | $95 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $59 | $99 | $140 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $65 | $150 | $193 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $84 | $84 | $84 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $91 | $189 | $238 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $112 | $112 | $112 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $40 | $59 | $79 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $45 | $55 | $65 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $3 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $82 | $123 | $164 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $59 | $78 | $110 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $47 | $101 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $39 | $88 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $102 | $127 | $152 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $15 | $22 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $4 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $52 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $53 | $60 | $68 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $84 | $301 | $518 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $19 | $99 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $54 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $120 | $658 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $807 | $918 | $1,030 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $28 | $189 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,369 | $2,817 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $181 | $274 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $774 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $392 | $596 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $163 | $277 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $258 | $280 | $291 |
| Septoplasty CPT 30520 • ENT | $355 | $510 | $665 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $134 | $174 | $215 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $115 | $161 | $184 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $204 | $235 | $250 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $183 | $307 | $431 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $272 | $302 | $317 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $133 | $161 | $175 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $214 | $237 | $259 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $342 | $360 | $370 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $112 | $163 | $188 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $182 | $250 | $285 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $192 | $245 | $297 |