| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $123 | $127 | $131 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $152 | $174 | $217 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $69 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $84 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $67 | $104 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $64 | $98 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $90 | $150 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $81 | $111 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $199 | $199 | $199 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $86 | $142 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $144 | $208 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $160 | $191 | $222 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $176 | $261 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $133 | $133 | $133 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $68 | $105 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $50 | $70 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $14 | $22 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $94 | $158 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $86 | $119 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $91 | $116 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $52 | $92 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $92 | $176 | $260 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $19 | $30 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $13 | $53 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $53 | $71 | $90 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $81 | $299 | $518 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $26 | $102 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $13 | $49 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $92 | $393 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $807 | $896 | $985 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $43 | $194 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $304 | $1,220 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $201 | $284 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $786 | $786 | $786 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $435 | $678 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $197 | $288 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $263 | $468 |
| Septoplasty CPT 30520 • ENT | $665 | $666 | $666 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $160 | $187 | $215 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $149 | $234 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $152 | $250 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $298 | $364 | $431 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $319 | $609 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $189 | $216 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $188 | $347 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $389 | $768 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $118 | $205 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $234 | $389 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $226 | $421 |