| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $104 | $127 | $151 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $153 | $170 | $186 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $63 | $117 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $91 | $145 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $75 | $121 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $45 | $60 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $90 | $150 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $93 | $182 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $124 | $133 | $142 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $98 | $148 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $90 | $150 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $187 | $187 | $187 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $113 | $205 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $157 | $157 | $157 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $83 | $123 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $57 | $92 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $13 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $107 | $183 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $86 | $134 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $106 | $115 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $84 | $98 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $99 | $144 | $189 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $33 | $33 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $7 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $66 | $70 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $12 | $12 | $12 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $143 | $143 | $143 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $16 | $18 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $40 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $60 | $394 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,459 | $1,459 | $1,459 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $46 | $158 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,276 | $2,658 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $198 | $198 | $198 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $865 | $955 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $429 | $614 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $226 | $280 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $290 | $550 |
| Septoplasty CPT 30520 • ENT | $786 | $786 | $786 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $283 | $283 | $283 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $133 | $204 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $243 | $371 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $340 | $340 | $340 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $266 | $502 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $210 | $245 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $218 | $407 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $332 | $634 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $136 | $242 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $181 | $331 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $194 | $357 |