| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $169 | $226 | $269 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $326 | $354 | $400 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $66 | $108 | $192 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $96 | $180 | $280 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $230 | $244 | $259 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $108 | $186 | $295 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $153 | $203 | $289 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $202 | $279 | $345 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $114 | $233 | $322 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $266 | $281 | $296 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $322 | $322 | $322 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $530 | $564 | $599 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $167 | $347 | $574 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $337 | $337 | $337 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $124 | $194 | $264 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $88 | $146 | $198 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $8 | $13 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $181 | $246 | $347 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $147 | $231 | $286 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $87 | $244 | $341 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $214 | $214 | $214 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $290 | $290 | $290 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $50 | $50 | $50 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $24 | $24 | $24 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $38 | $38 | $38 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $48 | $48 | $48 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $12 | $12 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $5 | $5 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $61 | $61 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $555 | $555 | $555 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $19 | $19 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,385 | $1,385 | $1,385 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $214 | $214 | $214 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $630 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $643 | $643 | $643 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $184 | $184 | $184 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $327 | $673 | $1,019 |
| Septoplasty CPT 30520 • ENT | $1,215 | $1,428 | $1,640 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $418 | $418 | $418 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $116 | $303 | $490 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $291 | $291 | $291 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $445 | $754 | $1,063 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $593 | $746 | $898 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $330 | $388 | $446 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $485 | $485 | $485 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $691 | $691 | $691 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $314 | $412 | $510 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $534 | $605 | $676 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $691 | $911 | $1,131 |