| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $123 | $245 | $367 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $152 | $165 | $177 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $291 | $321 | $351 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $157 | $295 | $434 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $119 | $240 | $360 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $338 | $374 | $410 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $367 | $408 | $449 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $307 | $424 | $541 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $497 | $549 | $601 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $408 | $449 | $489 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $359 | $529 | $699 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $672 | $752 | $832 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $482 | $692 | $902 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $594 | $661 | $728 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $165 | $264 | $363 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $191 | $217 | $243 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $18 | $19 | $20 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $462 | $504 | $546 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $325 | $363 | $401 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $383 | $429 | $476 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $112 | $201 | $290 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $152 | $163 | $173 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $8 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $73 | $73 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $53 | $53 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $690 | $690 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $178 | $178 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $76 | $76 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $927 | $927 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $807 | $807 | $807 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $270 | $270 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $3,041 | $3,041 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $368 | $368 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,015 | $1,015 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $799 | $799 | $799 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $333 | $333 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $834 | $1,227 | $1,619 |
| Septoplasty CPT 30520 • ENT | $1,904 | $2,104 | $2,303 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $421 | $630 | $838 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $561 | $664 | $766 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $744 | $849 | $954 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $729 | $878 | $1,026 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $973 | $1,239 | $1,506 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $540 | $642 | $743 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $795 | $995 | $1,195 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $1,135 | $1,518 | $1,901 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $399 | $554 | $708 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $859 | $977 | $1,096 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $896 | $1,017 | $1,137 |