| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $47 | $95 | $143 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $58 | $117 | $177 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $11 | $35 | $83 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $102 | $120 | $139 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $93 | $93 | $93 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $42 | $70 | $97 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $73 | $73 | $73 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $136 | $140 | $143 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $118 | $118 | $118 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $125 | $125 | $125 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $118 | $118 | $118 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $129 | $129 | $129 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $219 | $238 | $257 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $178 | $178 | $178 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $98 | $98 | $98 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $59 | $59 | $59 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $5 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $101 | $112 | $123 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $99 | $99 | $99 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $129 | $134 | $140 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $94 | $112 | $130 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $68 | $122 | $177 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $51 | $63 | $86 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $2 | $31 | $60 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $48 | $50 | $52 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $82 | $138 | $194 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $15 | $23 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $87 | $225 | $364 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $555 | $4,509 | $8,462 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $97 | $162 | $228 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $2,499 | $4,770 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $271 | $291 | $310 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $630 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $31 | $214 | $397 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $85 | $162 | $216 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $242 | $272 | $302 |
| Septoplasty CPT 30520 • ENT | $592 | $592 | $592 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $143 | $143 | $143 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $163 | $199 | $234 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $260 | $291 | $322 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $414 | $483 | $551 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $336 | $375 | $414 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $172 | $176 | $179 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $229 | $229 | $229 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $42 | $217 | $392 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $25 | $111 | $197 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $256 | $314 | $372 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $262 | $272 | $283 |