| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $10 | $56 | $101 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $92 | $107 | $122 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $7 | $66 | $125 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $77 | $85 | $93 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $77 | $101 | $125 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $12 | $12 | $12 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $51 | $51 | $51 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $94 | $94 | $94 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $43 | $85 | $128 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $16 | $16 | $16 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $33 | $90 | $148 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $203 | $203 | $203 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $157 | $174 | $190 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $14 | $14 | $14 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $6 | $6 | $6 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $43 | $43 | $43 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $2 | $2 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $53 | $53 | $53 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $5 | $46 | $87 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $17 | $59 | $102 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $38 | $56 | $75 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $10 | $83 | $157 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $64 | $75 | $86 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $10 | $36 | $63 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $74 | $321 | $568 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $167 | $170 | $173 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $26 | $44 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $714 | $855 | $995 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $9,031 | $9,031 | $9,032 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $201 | $263 | $325 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,922 | $2,549 | $3,175 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $24 | $134 | $243 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $100 | $100 | $100 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $78 | $78 | $78 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $16 | $89 | $161 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $33 | $194 | $355 |
| Septoplasty CPT 30520 • ENT | $491 | $806 | $1,120 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $11 | $11 | $11 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $58 | $115 | $172 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $31 | $118 | $205 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $208 | $349 | $490 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $72 | $188 | $304 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $177 | $266 | $355 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $114 | $178 | $242 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $43 | $89 | $135 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $99 | $99 | $99 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $289 | $294 | $299 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $301 | $301 | $301 |