| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $31 | $70 | $108 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $25 | $78 | $131 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $17 | $35 | $53 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $72 | $72 | $72 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $54 | $54 | $54 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $25 | $25 | $25 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $14 | $14 | $14 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $33 | $58 | $83 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $84 | $84 | $84 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $53 | $53 | $53 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $14 | $75 | $137 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $55 | $55 | $55 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $28 | $107 | $186 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $29 | $29 | $29 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $46 | $52 | $57 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $9 | $35 | $61 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $3 | $3 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $52 | $52 | $52 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $40 | $63 | $86 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $15 | $58 | $101 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $15 | $45 | $75 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $185 | $185 | $186 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $21 | $21 | $22 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $5 | $6 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $38 | $38 | $39 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $55 | $55 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $643 | $643 | $643 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $80 | $145 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $64 | $64 | $64 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $667 | $778 | $889 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $7,860 | $7,860 | $7,860 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $28 | $118 | $209 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $184 | $1,013 | $1,843 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $155 | $155 | $156 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $90 | $90 | $90 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $47 | $178 | $310 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $25 | $75 | $125 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $249 | $302 | $355 |
| Septoplasty CPT 30520 • ENT | $344 | $417 | $491 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $22 | $22 | $22 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $119 | $138 | $158 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $115 | $193 | $272 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $35 | $133 | $232 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $417 | $417 | $418 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $34 | $101 | $169 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $33 | $33 | $33 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $105 | $105 | $105 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $25 | $25 | $25 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $201 | $235 | $268 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $56 | $56 | $56 |