| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $47 | $68 | $88 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $57 | $57 | $57 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $69 | $82 | $95 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $84 | $100 | $116 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $100 | $100 | $100 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $45 | $62 | $80 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $120 | $120 | $120 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $99 | $114 | $129 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $88 | $125 | $162 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $99 | $99 | $99 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $188 | $188 | $188 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $219 | $219 | $219 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $129 | $155 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $194 | $194 | $194 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $90 | $97 | $105 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $51 | $54 | $57 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $6 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $118 | $134 | $150 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $63 | $94 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $109 | $125 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $110 | $110 | $110 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $155 | $155 | $155 |
| 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 | $18 | $45 | $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 | $139 | $139 | $139 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $139 | $139 | $139 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $420 | $420 | $420 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $228 | $228 | $228 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $112 | $197 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $172 | $172 | $172 |
| Septoplasty CPT 30520 • ENT | $619 | $619 | $619 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $207 | $207 | $207 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $184 | $184 | $184 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $152 | $152 | $152 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $402 | $402 | $402 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $312 | $312 | $312 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $174 | $174 | $174 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $255 | $255 | $255 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $364 | $364 | $364 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $183 | $183 | $183 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $277 | $277 | $277 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $289 | $289 | $289 |