| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $51 | $112 | $192 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $232 | $247 | $262 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $91 | $118 | $171 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $142 | $174 | $205 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $32 | $37 | $41 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $48 | $86 | $142 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $119 | $130 | $140 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $72 | $125 | $157 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $106 | $214 | $289 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $135 | $188 | $241 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $202 | $202 | $202 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $231 | $307 | $384 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $153 | $329 | $410 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $192 | $267 | $341 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $83 | $138 | $193 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $46 | $55 | $67 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $11 | $11 | $11 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $162 | $186 | $210 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $69 | $126 | $167 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $199 | $207 | $223 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $176 | $176 | $176 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $233 | $233 | $233 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $3 | $3 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $6 | $6 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $26 | $26 | $26 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $35 | $35 | $35 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $78 | $78 | $78 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $18 | $18 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $4 | $4 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $61 | $61 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $810 | $810 | $810 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $30 | $30 | $30 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,900 | $1,900 | $1,900 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $208 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $630 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $261 | $306 | $328 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $162 | $164 | $169 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $500 | $651 | $727 |
| Septoplasty CPT 30520 • ENT | $665 | $852 | $1,038 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $208 | $233 | $258 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $66 | $224 | $316 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $260 | $403 | $546 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $477 | $608 | $739 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $336 | $518 | $699 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $187 | $292 | $344 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $219 | $330 | $441 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $311 | $351 | $392 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $197 | $313 | $371 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $298 | $439 | $584 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $513 | $561 | $608 |