| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $116 | $169 | $222 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $211 | $250 | $343 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $121 | $178 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $110 | $162 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $91 | $141 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $93 | $156 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $155 | $237 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $168 | $277 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $41 | $170 | $317 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $138 | $203 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $167 | $330 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $190 | $289 | $379 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $319 | $405 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $198 | $217 | $241 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $106 | $184 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $62 | $92 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $20 | $41 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $144 | $350 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $146 | $202 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $158 | $183 | $216 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $88 | $144 | $164 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $74 | $379 | $718 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $13 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $6 | $43 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $44 | $52 | $74 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $56 | $229 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $21 | $136 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $50 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $70 | $553 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $750 | $891 | $1,202 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $33 | $213 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $1,872 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $197 | $297 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $742 | $887 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $330 | $492 | $799 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $178 | $254 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $356 | $627 |
| Septoplasty CPT 30520 • ENT | $506 | $778 | $926 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $41 | $183 | $306 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $214 | $384 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $276 | $422 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $180 | $423 | $650 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $456 | $960 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $203 | $279 | $468 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $288 | $759 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $464 | $1,212 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $120 | $220 | $285 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $377 | $630 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $333 | $681 |