| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $86 | $104 | $123 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $48 | $101 | $153 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $29 | $48 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $68 | $100 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $31 | $33 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $35 | $39 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $87 | $124 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $81 | $152 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $114 | $167 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $59 | $88 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $97 | $164 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $30 | $110 | $191 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $83 | $136 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $169 | $169 | $169 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $51 | $78 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $51 | $65 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $12 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $48 | $84 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $80 | $109 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $110 | $118 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $58 | $85 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $34 | $34 | $34 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $55 | $69 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $36 | $47 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $476 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $79 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $60 | $72 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $60 | $494 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $594 | $5,579 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $164 | $244 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $195 | $2,329 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $230 | $230 | $230 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $593 | $593 | $593 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $336 | $568 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $154 | $244 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $195 | $291 |
| Septoplasty CPT 30520 • ENT | $558 | $609 | $665 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $134 | $134 | $134 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $114 | $183 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $208 | $329 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $389 | $389 | $389 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $162 | $294 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $163 | $171 | $175 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $135 | $241 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $187 | $343 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $100 | $171 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $147 | $263 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $153 | $276 |