| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $90 | $103 | $115 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $109 | $126 | $142 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $25 | $70 | $93 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $87 | $99 | $111 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $76 | $76 | $76 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $83 | $83 | $83 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $59 | $59 | $59 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $110 | $110 | $110 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $122 | $122 | $122 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $100 | $100 | $100 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $142 | $160 | $179 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $165 | $165 | $165 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $177 | $206 | $221 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $42 | $94 | $146 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $40 | $41 | $42 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $39 | $39 | $39 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $4 | $4 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $113 | $113 | $113 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $48 | $75 | $102 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $111 | $120 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $83 | $96 | $109 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $48 | $97 | $147 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $12 | $38 | $66 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $26 | $39 | $51 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $350 | $653 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $90 | $169 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $29 | $53 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $74 | $87 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $3,895 | $7,265 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $22 | $26 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $286 | $1,513 | $2,869 |
| 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 | $312 | $327 | $342 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $169 | $171 | $173 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $204 | $279 | $316 |
| Septoplasty CPT 30520 • ENT | $466 | $594 | $722 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $156 | $156 | $156 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $138 | $170 | $201 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $115 | $193 | $271 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $176 | $323 | $469 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $235 | $287 | $338 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $131 | $169 | $188 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $192 | $192 | $192 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $274 | $274 | $274 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $138 | $163 | $188 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $209 | $244 | $280 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $218 | $218 | $218 |