| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $105 | $159 | $195 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $144 | $181 | $219 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $123 | $154 | $215 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $131 | $149 | $168 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $84 | $115 | $146 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $52 | $174 | $296 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $185 | $228 | $271 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $137 | $239 | $329 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $139 | $194 | $294 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $60 | $212 | $364 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $287 | $394 | $502 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $195 | $344 | $493 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $316 | $428 | $622 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $221 | $368 | $516 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $62 | $90 | $117 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $68 | $117 | $170 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $11 | $17 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $162 | $250 | $338 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $161 | $172 | $185 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $166 | $230 | $336 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $162 | $162 | $163 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $193 | $314 | $435 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $7 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $70 | $79 | $96 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $38 | $70 | $117 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $66 | $398 | $731 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $80 | $143 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $25 | $46 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $41 | $377 | $712 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $769 | $3,667 | $6,565 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $26 | $26 | $26 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,932 | $1,932 | $1,932 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $280 | $341 | $401 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $400 | $620 | $840 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $328 | $602 | $871 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $152 | $183 | $246 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $425 | $676 | $1,117 |
| Septoplasty CPT 30520 • ENT | $530 | $925 | $1,356 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $60 | $258 | $457 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $280 | $346 | $405 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $386 | $525 | $658 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $510 | $571 | $631 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $395 | $538 | $681 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $264 | $302 | $378 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $423 | $630 | $836 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $460 | $627 | $794 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $218 | $345 | $618 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $377 | $606 | $938 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $394 | $513 | $632 |