| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $120 | $158 | $199 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $194 | $294 | $394 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $87 | $105 | $124 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $131 | $140 | $149 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $43 | $156 | $269 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $47 | $172 | $296 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $98 | $211 | $324 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $122 | $256 | $397 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $132 | $236 | $436 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $182 | $273 | $364 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $255 | $378 | $502 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $166 | $373 | $581 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $309 | $466 | $622 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $260 | $290 | $321 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $63 | $100 | $138 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $86 | $112 | $139 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $8 | $12 | $17 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $107 | $268 | $428 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $143 | $205 | $287 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $167 | $252 | $336 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $322 | $322 | $322 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $179 | $179 | $179 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $19 | $61 | $96 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $51 | $87 | $117 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $66 | $94 | $122 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $24 | $30 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $11 | $15 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $88 | $129 | $169 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $769 | $1,102 | $1,435 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $26 | $36 | $47 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $533 | $1,233 | $1,932 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $280 | $346 | $411 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $733 | $987 | $1,241 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $608 | $750 | $892 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $254 | $313 | $372 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $378 | $810 | $1,117 |
| Septoplasty CPT 30520 • ENT | $530 | $1,153 | $2,141 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $281 | $485 | $689 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $248 | $397 | $592 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $343 | $530 | $808 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $561 | $664 | $766 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $353 | $686 | $1,019 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $197 | $382 | $567 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $290 | $563 | $836 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $411 | $800 | $1,190 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $256 | $400 | $618 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $336 | $593 | $938 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $351 | $666 | $982 |