| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $101 | $149 | $198 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $122 | $181 | $239 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $41 | $65 | $77 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $93 | $101 | $110 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $85 | $85 | $85 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $59 | $59 | $59 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $32 | $67 | $102 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $130 | $130 | $130 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $216 | $216 | $216 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $140 | $140 | $140 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $148 | $183 | $219 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $171 | $171 | $171 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $215 | $265 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $222 | $222 | $222 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $36 | $73 | $110 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $93 | $93 | $93 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $15 | $15 | $15 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $292 | $292 | $292 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $87 | $111 | $135 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $82 | $96 | $103 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $75 | $84 | $93 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $90 | $123 | $157 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $18 | $31 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $6 | $7 | $9 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $39 | $62 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $63 | $80 | $96 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $134 | $437 | $739 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $29 | $98 | $167 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $13 | $55 | $98 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $183 | $465 | $746 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,373 | $5,202 | $9,031 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $44 | $184 | $325 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $3,159 | $3,170 | $3,176 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $243 | $270 | $298 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $862 | $862 | $862 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $391 | $434 | $478 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $161 | $173 | $197 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $36 | $405 | $725 |
| Septoplasty CPT 30520 • ENT | $653 | $1,156 | $1,658 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $208 | $208 | $208 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $176 | $317 | $458 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $348 | $485 | $623 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $412 | $744 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $615 | $702 | $790 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $152 | $199 | $294 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $483 | $564 | $646 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $779 | $850 | $921 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $198 | $238 | $279 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $462 | $585 | $709 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $481 | $481 | $481 |