| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $48 | $88 | $127 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $110 | $133 | $157 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $60 | $88 | $103 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $88 | $105 | $123 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $28 | $28 | $28 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $74 | $74 | $74 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $101 | $101 | $101 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $75 | $75 | $75 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $123 | $123 | $123 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $85 | $85 | $85 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $142 | $171 | $199 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $124 | $124 | $124 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $178 | $223 | $246 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $125 | $145 | $165 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $39 | $39 | $39 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $47 | $47 | $47 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $1 | $1 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $113 | $113 | $113 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $81 | $97 | $114 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $120 | $134 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $84 | $98 | $111 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $117 | $131 | $146 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $4 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $24 | $52 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $35 | $37 | $39 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $95 | $295 | $494 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $69 | $127 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $5 | $5 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $63 | $66 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $3,138 | $5,752 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $30 | $42 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,153 | $2,346 | $2,731 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $175 | $208 | $242 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $630 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $326 | $331 | $342 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $151 | $170 | $208 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $205 | $286 | $327 |
| Septoplasty CPT 30520 • ENT | $523 | $634 | $746 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $116 | $143 | $169 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $169 | $188 | $208 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $114 | $198 | $281 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $247 | $365 | $482 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $348 | $356 | $365 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $130 | $173 | $194 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $288 | $288 | $288 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $460 | $460 | $460 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $98 | $160 | $222 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $256 | $293 | $330 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $217 | $282 | $347 |