| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $171 | $210 | $249 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $302 | $314 | $326 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $194 | $194 | $194 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $164 | $202 | $240 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $198 | $198 | $198 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $227 | $227 | $227 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $102 | $175 | $249 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $102 | $201 | $300 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $228 | $281 | $335 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $198 | $234 | $271 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $388 | $388 | $388 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $310 | $310 | $310 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $340 | $340 | $340 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $259 | $259 | $259 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $60 | $130 | $199 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $107 | $121 | $135 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $11 | $36 | $60 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $304 | $304 | $304 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $142 | $146 | $149 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $257 | $259 | $263 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $140 | $140 | $140 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $309 | $309 | $309 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $14 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $52 | $58 | $64 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $30 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $65 | $65 | $65 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $16 | $71 | $126 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $8 | $31 | $54 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $84 | $477 | $870 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $757 | $760 | $763 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $25 | $108 | $190 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,895 | $2,374 | $2,853 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $207 | $212 | $216 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $589 | $718 | $848 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $449 | $459 | $470 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $187 | $191 | $196 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $102 | $368 | $899 |
| Septoplasty CPT 30520 • ENT | $102 | $693 | $1,284 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $462 | $462 | $462 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $102 | $263 | $423 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $102 | $317 | $531 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $102 | $340 | $577 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $102 | $474 | $846 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $417 | $417 | $417 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $102 | $387 | $672 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $1,069 | $1,069 | $1,069 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $102 | $199 | $393 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $609 | $611 | $614 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $637 | $637 | $637 |