| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $68 | $131 | $194 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $82 | $160 | $238 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $135 | $145 | $154 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $165 | $176 | $187 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $55 | $109 | $162 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $65 | $67 | $69 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $112 | $152 | $193 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $153 | $194 | $235 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $173 | $202 | $230 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $189 | $203 | $216 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $167 | $234 | $302 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $223 | $267 | $312 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $336 | $354 | $372 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $206 | $258 | $310 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $82 | $116 | $150 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $89 | $94 | $99 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $6 | $10 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $173 | $210 | $248 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $92 | $131 | $170 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $135 | $167 | $199 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $110 | $110 | $110 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $157 | $157 | $157 |
| 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 | $52 | $52 | $52 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $14 | $14 | $14 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $49 | $49 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $12 | $12 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $5 | $5 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $63 | $63 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,089 | $1,089 | $1,089 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $19 | $19 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,438 | $1,438 | $1,438 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $210 | $210 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $823 | $823 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $425 | $425 | $425 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $210 | $210 | $210 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $387 | $416 | $446 |
| Septoplasty CPT 30520 • ENT | $883 | $949 | $1,014 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $228 | $261 | $293 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $260 | $277 | $294 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $345 | $365 | $385 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $338 | $499 | $660 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $451 | $469 | $488 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $200 | $236 | $272 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $369 | $384 | $400 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $526 | $548 | $570 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $260 | $276 | $292 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $299 | $368 | $437 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $415 | $436 | $456 |