| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $163 | $268 | $373 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $152 | $198 | $243 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $55 | $77 | $99 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $80 | $222 | $364 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $45 | $60 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $54 | $78 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $78 | $125 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $134 | $303 | $473 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $117 | $320 | $523 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $86 | $142 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $100 | $170 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $30 | $110 | $189 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $158 | $452 | $746 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $30 | $101 | $172 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $112 | $230 | $348 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $70 | $139 | $209 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $10 | $15 | $20 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $206 | $356 | $507 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $113 | $228 | $344 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $83 | $136 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $70 | $100 | $119 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $152 | $195 | $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 | $44 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $12 | $33 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $96 | $393 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $24 | $101 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $12 | $44 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $133 | $530 | $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 | $153 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $420 | $1,730 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $322 | $345 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $977 | $996 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $699 | $749 | $799 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $291 | $312 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $355 | $628 | $901 |
| Septoplasty CPT 30520 • ENT | $866 | $1,457 | $2,049 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $30 | $160 | $291 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $295 | $434 | $574 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $230 | $430 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $30 | $163 | $296 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $244 | $459 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $180 | $184 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $190 | $350 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $337 | $643 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $150 | $270 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $251 | $472 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $252 | $475 |