| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $100 | $152 | $203 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $62 | $93 | $123 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $77 | $79 | $81 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $96 | $146 | $197 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $41 | $63 | $84 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $34 | $76 | $119 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $100 | $119 | $138 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $80 | $99 | $118 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $134 | $154 | $174 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $113 | $133 | $153 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $155 | $237 | $320 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $178 | $210 | $242 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $260 | $400 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $156 | $156 | $156 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $85 | $87 | $89 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $50 | $51 | $52 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $5 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $132 | $147 | $161 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $89 | $101 | $114 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $104 | $140 | $212 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $89 | $90 | $92 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $68 | $95 | $122 |
| 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 | $9 | $34 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $26 | $26 | $26 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $31 | $31 | $31 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $8 | $8 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $44 | $84 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $42 | $42 | $42 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $350 | $350 | $350 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $18 | $18 | $18 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $924 | $924 | $924 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $174 | $194 | $215 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $498 | $511 | $525 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $318 | $364 | $456 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $141 | $165 | $177 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $219 | $276 | $305 |
| Septoplasty CPT 30520 • ENT | $697 | $697 | $698 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $230 | $291 | $352 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $197 | $197 | $197 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $164 | $213 | $262 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $453 | $454 | $456 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $321 | $330 | $339 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $140 | $165 | $178 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $262 | $348 | $434 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $374 | $383 | $392 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $132 | $212 | $311 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $283 | $377 | $471 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $233 | $265 | $296 |