| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $49 | $98 | $123 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $59 | $121 | $152 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $32 | $34 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $52 | $97 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $102 | $103 | $104 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $85 | $113 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $121 | $123 | $124 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $102 | $127 | $152 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $165 | $166 | $167 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $135 | $138 | $139 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $191 | $192 | $193 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $146 | $184 | $222 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $186 | $240 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $197 | $198 | $198 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $72 | $107 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $49 | $65 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $14 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $153 | $158 | $163 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $65 | $94 | $109 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $103 | $128 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $110 | $111 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $66 | $123 | $152 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $13 | $53 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $38 | $48 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $476 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $123 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $52 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $361 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $5,572 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $164 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $216 | $1,650 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $315 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $823 | $919 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $456 | $713 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $190 | $297 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $197 | $291 |
| Septoplasty CPT 30520 • ENT | $631 | $654 | $665 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $140 | $168 | $215 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $63 | $143 | $183 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $246 | $249 | $250 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $241 | $368 | $431 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $317 | $319 | $322 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $30 | $103 | $179 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $184 | $263 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $369 | $371 | $376 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $148 | $188 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $284 | $284 | $284 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $297 | $297 | $297 |