| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $85 | $119 | $153 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $76 | $76 | $76 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $75 | $75 | $75 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $103 | $103 | $103 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $41 | $41 | $41 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $50 | $50 | $50 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $129 | $129 | $129 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $114 | $114 | $114 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $75 | $126 | $178 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $143 | $143 | $143 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $202 | $202 | $202 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $247 | $247 | $247 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $162 | $169 | $185 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $214 | $214 | $214 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $33 | $48 | $64 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $36 | $49 | $63 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $3 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $154 | $154 | $154 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $75 | $76 | $77 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $88 | $107 | $144 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $75 | $75 | $75 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $194 | $194 | $194 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $23 | $23 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $7 | $7 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $37 | $37 | $37 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $49 | $49 | $49 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $76 | $76 | $76 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $17 | $17 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $10 | $10 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $104 | $104 | $104 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $932 | $932 | $932 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $34 | $34 | $34 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,185 | $2,185 | $2,185 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $251 | $251 | $251 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $791 | $791 | $791 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $412 | $412 | $412 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $203 | $203 | $203 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $481 | $481 | $481 |
| Septoplasty CPT 30520 • ENT | $691 | $691 | $691 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $245 | $245 | $245 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $167 | $188 | $209 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $223 | $294 | $365 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $325 | $325 | $325 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $477 | $477 | $477 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $235 | $235 | $235 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $378 | $378 | $378 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $603 | $603 | $603 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $112 | $162 | $211 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $339 | $339 | $339 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $353 | $353 | $353 |