| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $51 | $116 | $148 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $150 | $175 | $183 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $25 | $76 | $119 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $43 | $43 | $43 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $56 | $56 | $56 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $67 | $67 | $67 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $36 | $80 | $149 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $36 | $93 | $183 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $36 | $54 | $90 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $112 | $112 | $112 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $149 | $149 | $149 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $117 | $117 | $117 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $186 | $186 | $186 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $154 | $154 | $154 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $44 | $78 | $94 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $36 | $38 | $43 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $6 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $146 | $146 | $146 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $36 | $39 | $50 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $97 | $97 | $97 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $43 | $43 | $43 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $58 | $58 | $58 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $18 | $18 | $18 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $6 | $6 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $7 | $7 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $42 | $42 | $42 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $77 | $77 | $77 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $17 | $17 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $9 | $9 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $109 | $109 | $109 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $944 | $944 | $944 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $26 | $26 | $26 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $221 | $221 | $221 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $161 | $161 | $161 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $710 | $710 | $710 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $350 | $350 | $350 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $146 | $146 | $146 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $349 | $366 | $416 |
| Septoplasty CPT 30520 • ENT | $581 | $726 | $799 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $220 | $220 | $220 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $83 | $186 | $221 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $300 | $310 | $341 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $310 | $310 | $310 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $460 | $460 | $460 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $225 | $225 | $225 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $36 | $255 | $363 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $444 | $478 | $580 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $188 | $188 | $188 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $318 | $336 | $342 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $36 | $271 | $357 |