| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $288 | $308 | $336 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $130 | $233 | $417 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $33 | $169 | $242 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $50 | $165 | $327 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $102 | $173 | $243 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $106 | $115 | $123 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $225 | $259 | $294 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $102 | $210 | $285 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $277 | $327 | $395 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $215 | $330 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $281 | $405 | $530 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $398 | $462 | $526 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $563 | $610 | $657 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $290 | $315 | $339 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $147 | $265 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $112 | $180 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $9 | $16 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $228 | $388 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $64 | $209 | $304 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $304 | $330 | $355 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $177 | $177 | $177 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $98 | $98 | $98 |
| 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 | $7 | $7 | $7 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $4 | $4 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $38 | $38 | $38 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $10 | $10 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $4 | $4 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $50 | $50 | $50 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $440 | $440 | $440 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $15 | $15 | $15 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,104 | $1,104 | $1,104 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $160 | $160 | $160 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $419 | $419 | $419 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $348 | $348 | $348 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $145 | $145 | $145 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $412 | $643 | $800 |
| Septoplasty CPT 30520 • ENT | $1,569 | $1,678 | $1,831 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $367 | $428 | $505 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $149 | $369 | $506 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $250 | $436 | $691 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $1,013 | $1,098 | $1,182 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $747 | $799 | $872 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $30 | $293 | $433 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $453 | $715 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $872 | $933 | $1,018 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $188 | $334 | $446 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $285 | $584 | $789 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $708 | $758 | $826 |