| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $149 | $192 | $236 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $186 | $236 | $285 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $119 | $142 | $187 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $99 | $163 | $228 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $69 | $133 | $197 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $84 | $151 | $217 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $155 | $195 | $236 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $195 | $195 | $196 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $216 | $268 | $320 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $194 | $195 | $197 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $368 | $369 | $370 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $425 | $428 | $430 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $455 | $459 | $463 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $233 | $235 | $237 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $99 | $153 | $207 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $101 | $112 | $122 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $8 | $13 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $296 | $305 | $314 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $126 | $131 | $137 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $160 | $215 | $246 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $216 | $216 | $216 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $304 | $304 | $304 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $9 | $9 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $35 | $35 | $35 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $47 | $47 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $12 | $12 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $5 | $5 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $61 | $61 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $525 | $525 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $17 | $17 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,385 | $1,385 | $1,385 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $208 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $630 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $342 | $342 | $342 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $169 | $169 | $169 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $337 | $445 | $553 |
| Septoplasty CPT 30520 • ENT | $1,217 | $1,240 | $1,264 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $286 | $347 | $408 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $120 | $236 | $353 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $300 | $388 | $477 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $461 | $639 | $817 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $591 | $603 | $614 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $330 | $335 | $341 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $485 | $494 | $502 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $690 | $703 | $717 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $255 | $307 | $360 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $540 | $542 | $545 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $565 | $567 | $569 |