| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $43 | $87 | $132 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $135 | $149 | $164 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $79 | $108 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $71 | $100 | $128 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $29 | $29 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $78 | $123 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $89 | $89 | $89 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $75 | $75 | $75 |
| 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 | $99 | $99 | $99 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $84 | $146 | $207 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $109 | $109 | $109 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $185 | $232 | $255 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $146 | $146 | $146 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $46 | $46 | $46 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $41 | $41 | $41 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $6 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $100 | $102 | $103 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $86 | $103 | $120 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $101 | $126 | $140 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $50 | $86 | $122 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $122 | $139 | $156 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $15 | $25 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $53 | $55 | $56 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $39 | $55 | $71 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $83 | $297 | $512 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $19 | $81 | $143 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $8 | $11 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $114 | $505 | $896 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,010 | $3,787 | $6,565 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $28 | $36 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $215 | $1,773 | $2,736 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $175 | $192 | $210 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $376 | $509 | $643 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $33 | $211 | $389 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $15 | $116 | $180 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $32 | $244 | $366 |
| Septoplasty CPT 30520 • ENT | $461 | $649 | $836 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $102 | $190 | $277 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $149 | $193 | $237 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $256 | $286 | $316 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $218 | $380 | $542 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $322 | $351 | $380 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $158 | $194 | $212 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $254 | $283 | $311 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $406 | $424 | $443 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $145 | $190 | $236 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $226 | $285 | $344 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $236 | $299 | $361 |