| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $157 | $216 | $327 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $81 | $146 | $205 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $100 | $181 | $263 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $50 | $132 | $162 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $99 | $99 | $99 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $122 | $122 | $122 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $220 | $220 | $220 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $108 | $153 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $168 | $216 | $304 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $372 | $372 | $372 |
| 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 | $30 | $314 | $597 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $638 | $638 | $638 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $170 | $170 | $170 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $79 | $136 | $172 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $65 | $104 | $174 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $7 | $11 | $17 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $94 | $252 | $441 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $110 | $185 | $294 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $111 | $166 | $200 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $266 | $266 | $266 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $354 | $354 | $354 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $3 | $3 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $1 | $1 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $26 | $26 | $26 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $25 | $25 | $25 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $37 | $37 | $37 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $8 | $8 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $4 | $4 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $42 | $42 | $42 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $382 | $382 | $382 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $13 | $13 | $13 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $959 | $959 | $959 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $140 | $140 | $140 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $371 | $371 | $371 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $316 | $316 | $316 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $144 | $144 | $144 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $291 | $431 | $609 |
| Septoplasty CPT 30520 • ENT | $870 | $885 | $900 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $445 | $445 | $445 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $62 | $132 | $247 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $250 | $342 | $439 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $504 | $504 | $504 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $317 | $397 | $444 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $239 | $284 | $374 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $229 | $363 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $370 | $474 | $785 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $156 | $256 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $285 | $369 | $407 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $297 | $357 | $425 |