| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $123 | $130 | $136 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $68 | $124 | $153 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $65 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $67 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $58 | $86 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $34 | $39 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $54 | $103 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $90 | $137 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $94 | $94 | $94 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $58 | $115 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $108 | $193 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $143 | $143 | $143 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $167 | $237 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $183 | $190 | $198 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $60 | $91 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $45 | $53 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $17 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $80 | $129 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $81 | $109 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $83 | $113 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $66 | $97 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $133 | $143 | $152 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $16 | $24 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $5 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $55 | $67 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $48 | $51 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $369 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $95 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $30 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $123 | $659 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $807 | $947 | $1,087 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $34 | $192 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,385 | $2,489 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $221 | $295 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $823 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $342 | $571 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $169 | $278 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $185 | $291 |
| Septoplasty CPT 30520 • ENT | $532 | $599 | $665 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $211 | $211 | $211 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $89 | $183 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $157 | $250 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $202 | $316 | $431 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $205 | $317 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $149 | $167 | $175 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $125 | $220 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $172 | $314 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $83 | $136 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $184 | $284 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $139 | $249 |