| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $177 | $216 | $255 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $215 | $262 | $309 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $120 | $136 | $144 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $163 | $178 | $192 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $82 | $102 | $123 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $132 | $140 | $148 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $89 | $147 | $204 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $167 | $208 | $249 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $186 | $232 | $278 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $167 | $196 | $226 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $311 | $311 | $311 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $174 | $279 | $384 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $372 | $388 | $422 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $333 | $333 | $333 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $79 | $126 | $173 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $93 | $116 | $139 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $8 | $13 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $164 | $236 | $307 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $173 | $184 | $196 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $154 | $179 | $230 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $98 | $121 | $144 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $420 | $420 | $420 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $40 | $40 | $40 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $10 | $10 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $59 | $59 | $59 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $112 | $112 | $112 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $130 | $130 | $130 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $29 | $29 | $29 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $17 | $17 | $17 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $180 | $180 | $180 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,592 | $1,592 | $1,592 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $56 | $56 | $56 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $3,732 | $3,732 | $3,732 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $290 | $321 | $352 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,014 | $1,014 | $1,014 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $476 | $590 | $703 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $285 | $285 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $811 | $904 | $998 |
| Septoplasty CPT 30520 • ENT | $1,169 | $1,169 | $1,169 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $205 | $314 | $422 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $345 | $353 | $362 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $621 | $621 | $621 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $749 | $749 | $749 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $1,619 | $1,619 | $1,619 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $1,678 | $1,678 | $1,678 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $899 | $899 | $899 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $1,439 | $1,439 | $1,439 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $148 | $301 | $386 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $915 | $915 | $915 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $839 | $839 | $839 |