| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $35 | $113 | $203 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $123 | $125 | $129 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $26 | $89 | $162 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $96 | $99 | $104 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $46 | $81 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $34 | $52 | $89 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $64 | $87 | $133 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $80 | $97 | $131 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $134 | $138 | $146 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $81 | $140 | $226 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $152 | $154 | $155 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $178 | $243 | $372 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $260 | $400 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $156 | $156 | $156 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $38 | $73 | $95 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $42 | $66 | $105 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $6 | $10 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $74 | $75 | $76 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $89 | $95 | $109 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $72 | $93 | $104 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $92 | $104 | $128 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $122 | $123 | $125 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $15 | $48 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $35 | $35 | $35 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $49 | $49 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $10 | $10 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $44 | $63 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $61 | $61 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $437 | $437 | $437 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $17 | $17 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,154 | $1,154 | $1,154 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $213 | $215 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $498 | $507 | $525 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $285 | $307 | $318 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $177 | $181 | $190 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $263 | $291 | $305 |
| Septoplasty CPT 30520 • ENT | $499 | $631 | $697 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $159 | $247 | $352 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $94 | $162 | $197 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $262 | $312 | $411 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $241 | $431 | $599 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $252 | $298 | $321 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $178 | $207 | $266 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $206 | $244 | $262 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $374 | $436 | $561 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $132 | $157 | $192 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $283 | $300 | $334 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $233 | $275 | $296 |