| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $72 | $117 | $161 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $132 | $163 | $195 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $83 | $98 | $128 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $104 | $130 | $156 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $135 | $135 | $135 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $148 | $148 | $148 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $105 | $105 | $105 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $102 | $149 | $196 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $148 | $158 | $168 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $133 | $133 | $133 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $168 | $211 | $253 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $191 | $191 | $191 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $209 | $264 | $375 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $173 | $217 | $260 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $54 | $98 | $142 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $83 | $83 | $83 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $8 | $8 | $8 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $84 | $143 | $202 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $96 | $120 | $143 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $106 | $111 | $113 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $113 | $119 | $124 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $152 | $163 | $175 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $4 | $4 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $8 | $51 | $93 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $29 | $41 | $52 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $52 | $64 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $90 | $170 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $6 | $7 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $51 | $352 | $653 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $437 | $3,885 | $7,332 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $20 | $25 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $287 | $1,468 | $2,962 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $174 | $201 | $228 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $525 | $525 | $525 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $285 | $344 | $377 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $141 | $184 | $207 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $295 | $318 | $365 |
| Septoplasty CPT 30520 • ENT | $677 | $754 | $832 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $152 | $215 | $279 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $187 | $217 | $247 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $205 | $230 | $255 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $437 | $489 | $541 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $322 | $371 | $420 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $183 | $200 | $233 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $343 | $343 | $343 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $490 | $490 | $490 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $198 | $216 | $246 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $306 | $339 | $373 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $389 | $389 | $389 |