| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $88 | $155 | $211 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $79 | $170 | $262 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $69 | $116 | $133 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $70 | $120 | $205 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $53 | $59 | $64 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $80 | $143 | $195 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $167 | $184 | $217 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $129 | $201 | $265 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $173 | $291 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $138 | $160 | $183 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $263 | $299 | $334 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $252 | $279 | $306 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $283 | $415 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $271 | $307 | $344 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $92 | $122 | $152 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $49 | $85 | $115 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $14 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $118 | $165 | $210 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $81 | $143 | $192 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $167 | $225 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $154 | $154 | $154 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $216 | $216 | $216 |
| 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 | $6 | $6 | $6 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $23 | $50 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $31 | $31 | $31 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $11 | $14 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $21 | $38 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $41 | $60 | $79 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $350 | $350 | $350 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $11 | $11 | $11 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $924 | $924 | $924 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $139 | $254 | $369 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $420 | $718 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $228 | $228 | $228 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $112 | $199 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $240 | $377 | $501 |
| Septoplasty CPT 30520 • ENT | $865 | $1,007 | $1,148 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $192 | $225 | $258 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $245 | $272 | $315 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $213 | $329 | $435 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $563 | $650 | $738 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $425 | $470 | $547 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $237 | $239 | $243 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $350 | $385 | $449 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $498 | $549 | $640 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $232 | $244 | $256 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $388 | $426 | $500 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $404 | $444 | $522 |