| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $50 | $80 | $110 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $137 | $142 | $146 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $59 | $79 | $89 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $47 | $77 | $107 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $59 | $59 | $59 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $40 | $71 | $103 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $101 | $101 | $101 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $91 | $91 | $91 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $101 | $101 | $101 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $88 | $91 | $94 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $105 | $140 | $175 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $195 | $199 | $203 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $147 | $194 | $218 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $111 | $111 | $111 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $49 | $49 | $49 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $49 | $49 | $49 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $7 | $7 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $155 | $155 | $155 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $60 | $80 | $99 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $76 | $103 | $117 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $58 | $80 | $101 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $137 | $144 | $150 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $14 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $24 | $33 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $25 | $45 | $65 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $76 | $195 | $314 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $50 | $82 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $19 | $27 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $104 | $265 | $427 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $932 | $2,264 | $3,596 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $34 | $81 | $129 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,392 | $1,657 | $2,185 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $245 | $270 | $294 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $733 | $733 | $733 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $374 | $412 | $450 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $171 | $194 | $205 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $262 | $454 | $725 |
| Septoplasty CPT 30520 • ENT | $543 | $1,101 | $1,658 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $116 | $116 | $116 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $70 | $264 | $458 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $286 | $455 | $623 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $257 | $666 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $377 | $583 | $790 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $16 | $72 | $185 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $239 | $269 | $299 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $477 | $699 | $921 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $124 | $151 | $179 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $267 | $488 | $709 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $278 | $284 | $289 |