| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $123 | $185 | $269 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $152 | $243 | $335 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $55 | $84 | $99 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $80 | $106 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $60 | $89 | $104 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $78 | $101 | $113 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $124 | $124 | $125 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $134 | $209 | $341 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $117 | $220 | $377 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $139 | $197 | $312 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $170 | $185 | $193 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $189 | $211 | $222 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $158 | $311 | $539 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $172 | $189 | $198 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $112 | $206 | $254 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $65 | $95 | $150 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $9 | $15 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $163 | $245 | $366 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $109 | $157 | $248 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $128 | $185 | $292 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $70 | $107 | $119 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $152 | $198 | $253 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $15 | $54 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $12 | $39 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $96 | $492 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $24 | $127 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $12 | $55 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $133 | $662 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $8,071 | $8,071 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $37 | $192 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $420 | $2,167 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $322 | $353 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $977 | $1,002 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $699 | $766 | $799 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $291 | $319 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $291 | $432 | $650 |
| Septoplasty CPT 30520 • ENT | $665 | $1,003 | $1,479 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $215 | $240 | $291 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $183 | $297 | $414 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $250 | $421 | $582 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $296 | $386 | $431 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $317 | $364 | $459 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $178 | $184 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $259 | $289 | $350 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $369 | $460 | $643 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $188 | $215 | $270 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $284 | $347 | $472 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $297 | $356 | $475 |