| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $20 | $64 | $108 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $83 | $107 | $131 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $76 | $82 | $86 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $63 | $68 | $72 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $79 | $79 | $79 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $34 | $34 | $34 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $90 | $92 | $95 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $76 | $93 | $110 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $84 | $84 | $84 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $75 | $76 | $77 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $137 | $142 | $148 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $30 | $101 | $171 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $118 | $174 | $218 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $110 | $116 | $122 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $61 | $61 | $61 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $36 | $36 | $36 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $3 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $74 | $118 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $61 | $73 | $86 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $61 | $92 | $115 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $75 | $81 | $87 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $102 | $143 | $185 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $13 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $5 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $19 | $34 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $38 | $47 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $77 | $279 | $482 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $78 | $145 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $41 | $58 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $92 | $284 | $476 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $555 | $4,208 | $7,860 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $32 | $107 | $182 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $1,676 | $2,411 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $155 | $217 | $280 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $663 | $663 | $663 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $357 | $458 | $559 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $125 | $165 | $226 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $166 | $321 | $441 |
| Septoplasty CPT 30520 • ENT | $491 | $556 | $621 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $30 | $122 | $215 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $158 | $174 | $190 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $174 | $223 | $272 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $130 | $181 | $232 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $302 | $359 | $417 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $168 | $185 | $194 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $247 | $253 | $259 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $115 | $200 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $25 | $117 | $188 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $151 | $209 | $268 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $157 | $157 | $157 |