| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $51 | $90 | $113 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $61 | $117 | $136 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $38 | $66 | $102 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $81 | $89 | $125 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $38 | $66 | $108 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $38 | $77 | $119 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $84 | $99 | $104 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $126 | $132 | $157 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $111 | $174 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $87 | $105 | $114 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $193 | $196 | $202 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $195 | $208 | $235 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $183 | $253 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $198 | $203 | $208 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $82 | $104 | $172 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $48 | $62 | $70 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $21 | $38 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $38 | $123 | $162 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $69 | $89 | $97 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $115 | $146 | $200 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $77 | $87 | $118 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $166 | $182 | $189 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $27 | $34 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $48 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $269 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $79 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $43 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $248 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $5,556 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $163 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $304 | $1,577 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $237 | $251 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $737 | $791 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $342 | $647 | $799 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $169 | $225 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $136 | $322 | $429 |
| Septoplasty CPT 30520 • ENT | $601 | $720 | $1,012 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $133 | $169 | $225 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $86 | $157 | $198 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $260 | $350 | $439 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $431 | $432 | $433 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $336 | $377 | $391 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $187 | $192 | $193 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $38 | $243 | $310 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $374 | $436 | $492 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $124 | $167 | $197 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $264 | $318 | $407 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $275 | $331 | $425 |