| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $88 | $112 | $125 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $151 | $152 | $153 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $64 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $69 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $64 | $104 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $73 | $113 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $58 | $80 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $93 | $129 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $103 | $132 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $93 | $139 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $124 | $193 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $179 | $179 | $179 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $125 | $237 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $99 | $149 | $198 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $59 | $95 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $47 | $64 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $14 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $115 | $163 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $79 | $109 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $113 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $54 | $93 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $147 | $149 | $152 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $16 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $5 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $13 | $42 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $15 | $47 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $69 | $84 | $98 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $71 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $50 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $79 | $518 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $807 | $1,004 | $1,202 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $33 | $191 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,764 | $2,949 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $211 | $289 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $904 | $959 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $458 | $629 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $191 | $286 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $227 | $359 |
| Septoplasty CPT 30520 • ENT | $499 | $582 | $665 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $150 | $169 | $188 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $94 | $183 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $188 | $284 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $251 | $341 | $431 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $239 | $370 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $177 | $182 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $161 | $293 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $288 | $466 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $72 | $157 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $190 | $284 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $198 | $297 |