| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $54 | $91 | $112 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $130 | $154 | $179 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $76 | $92 | $116 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $102 | $121 | $140 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $80 | $95 | $122 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $53 | $74 | $96 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $106 | $126 | $147 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $122 | $124 | $127 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $128 | $134 | $142 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $115 | $118 | $122 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $140 | $152 | $164 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $171 | $183 | $196 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $185 | $199 | $212 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $145 | $158 | $171 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $62 | $71 | $80 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $53 | $58 | $63 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $8 | $8 | $8 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $114 | $121 | $128 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $77 | $92 | $105 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $112 | $132 | $152 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $64 | $96 | $133 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $74 | $105 | $136 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $6 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $5 | $34 | $63 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $26 | $62 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $96 | $406 | $753 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $31 | $113 | $184 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $6 | $53 | $107 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $414 | $1,005 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $594 | $3,706 | $9,052 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $16 | $119 | $304 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $195 | $1,681 | $3,168 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $198 | $214 | $230 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $69 | $309 | $549 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $336 | $366 | $397 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $154 | $157 | $160 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $343 | $491 | $664 |
| Septoplasty CPT 30520 • ENT | $657 | $721 | $785 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $176 | $209 | $242 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $217 | $219 | $222 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $184 | $229 | $273 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $288 | $397 | $507 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $374 | $398 | $423 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $208 | $208 | $209 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $306 | $321 | $336 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $436 | $485 | $534 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $157 | $189 | $221 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $337 | $338 | $338 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $350 | $352 | $354 |