| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $59 | $107 | $155 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $55 | $104 | $153 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $55 | $77 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $76 | $98 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $56 | $81 | $105 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $53 | $79 | $114 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $125 | $138 | $151 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $125 | $139 | $153 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $44 | $124 | $204 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $140 | $154 | $168 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $148 | $171 | $193 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $123 | $123 | $123 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $238 | $267 | $296 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $102 | $102 | $102 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $48 | $63 | $79 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $53 | $65 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $4 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $118 | $141 | $164 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $107 | $117 | $134 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $129 | $143 | $157 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $112 | $125 | $138 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $59 | $59 | $59 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $21 | $21 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $5 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $41 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $58 | $58 | $58 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $76 | $76 | $76 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $17 | $17 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $40 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $104 | $516 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $932 | $932 | $932 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $11 | $141 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,185 | $2,613 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $190 | $190 | $190 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $420 | $420 | $420 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $412 | $606 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $112 | $223 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $291 | $316 | $341 |
| Septoplasty CPT 30520 • ENT | $779 | $779 | $779 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $110 | $110 | $110 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $184 | $208 | $231 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $250 | $259 | $269 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $506 | $506 | $506 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $317 | $355 | $393 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $173 | $174 | $175 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $259 | $269 | $279 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $370 | $407 | $445 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $155 | $172 | $188 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $285 | $317 | $349 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $260 | $279 | $297 |