| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $35 | $84 | $118 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $123 | $130 | $143 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $33 | $65 | $81 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $50 | $81 | $96 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $50 | $84 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $92 | $97 | $109 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $64 | $82 | $118 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $80 | $100 | $122 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $134 | $143 | $159 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $81 | $108 | $131 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $114 | $141 | $155 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $140 | $165 | $178 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $204 | $232 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $190 | $190 | $190 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $38 | $43 | $52 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $42 | $48 | $61 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $4 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $74 | $99 | $132 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $51 | $81 | $105 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $77 | $95 | $104 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $92 | $97 | $108 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $48 | $107 | $152 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $15 | $46 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $35 | $35 | $35 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $47 | $47 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $12 | $12 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $51 | $84 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $61 | $61 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $525 | $525 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $17 | $17 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,385 | $1,385 | $1,385 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $213 | $215 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $498 | $542 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $318 | $326 | $342 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $169 | $174 | $177 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $169 | $217 | $305 |
| Septoplasty CPT 30520 • ENT | $609 | $667 | $697 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $204 | $221 | $230 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $181 | $191 | $197 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $150 | $225 | $262 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $230 | $308 | $453 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $307 | $316 | $321 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $171 | $176 | $178 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $251 | $259 | $262 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $358 | $369 | $374 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $132 | $168 | $192 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $273 | $280 | $283 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $284 | $292 | $296 |