| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $67 | $163 | $269 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $70 | $243 | $335 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $66 | $66 | $67 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $84 | $124 | $163 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $65 | $65 | $65 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $44 | $100 | $156 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $129 | $147 | $166 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $99 | $153 | $206 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $165 | $195 | $225 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $146 | $146 | $146 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $98 | $98 | $98 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $129 | $129 | $129 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $167 | $185 | $203 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $170 | $170 | $170 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $83 | $83 | $83 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $36 | $40 | $44 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $8 | $9 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $209 | $215 | $222 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $104 | $125 | $147 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $87 | $101 | $116 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $72 | $72 | $72 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $178 | $178 | $178 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $31 | $31 | $31 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $9 | $9 | $9 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $62 | $62 | $62 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $96 | $96 | $96 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $134 | $134 | $134 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $29 | $29 | $29 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $13 | $13 | $13 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $183 | $183 | $183 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,373 | $1,373 | $1,373 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $41 | $41 | $41 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $3,159 | $3,159 | $3,159 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $298 | $298 | $298 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $862 | $862 | $862 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $478 | $478 | $478 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $197 | $197 | $197 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $347 | $347 | $347 |
| Septoplasty CPT 30520 • ENT | $497 | $497 | $497 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $160 | $160 | $160 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $135 | $135 | $135 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $265 | $265 | $265 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $311 | $311 | $311 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $463 | $463 | $463 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $222 | $222 | $222 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $364 | $364 | $364 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $587 | $587 | $587 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $215 | $215 | $215 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $352 | $352 | $352 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $366 | $366 | $366 |