| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $172 | $187 | $202 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $209 | $229 | $244 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $43 | $145 | $226 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $134 | $195 | $248 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $95 | $121 | $168 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $44 | $120 | $193 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $44 | $143 | $209 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $64 | $176 | $252 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $163 | $174 | $186 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $64 | $161 | $227 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $271 | $271 | $271 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $213 | $264 | $315 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $234 | $441 | $576 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $179 | $179 | $179 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $44 | $120 | $178 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $64 | $98 | $116 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $10 | $36 | $55 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $44 | $200 | $309 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $100 | $171 | $228 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $123 | $233 | $304 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $97 | $97 | $97 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $235 | $235 | $235 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $40 | $40 | $40 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $11 | $11 | $11 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $58 | $58 | $58 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $78 | $80 | $83 |
| 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 | $176 | $176 | $176 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,589 | $1,589 | $1,589 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $57 | $57 | $57 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $559 | $559 | $559 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $330 | $330 | $330 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $989 | $989 | $989 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $591 | $630 | $686 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $284 | $284 | $284 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $645 | $764 | $905 |
| Septoplasty CPT 30520 • ENT | $905 | $1,097 | $1,288 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $194 | $197 | $200 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $284 | $354 | $428 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $455 | $489 | $533 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $397 | $486 | $575 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $581 | $705 | $843 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $287 | $407 | $467 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $461 | $586 | $751 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $733 | $933 | $1,194 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $44 | $257 | $444 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $427 | $512 | $610 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $64 | $343 | $521 |