| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $149 | $159 | $169 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $181 | $193 | $206 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $33 | $192 | $351 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $56 | $212 | $434 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $68 | $180 | $360 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $81 | $243 | $410 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $78 | $247 | $449 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $145 | $331 | $541 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $118 | $403 | $601 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $106 | $325 | $489 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $103 | $453 | $699 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $137 | $469 | $832 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $211 | $530 | $902 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $176 | $496 | $728 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $74 | $239 | $363 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $69 | $159 | $243 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $12 | $16 | $20 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $198 | $391 | $546 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $99 | $226 | $401 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $77 | $267 | $476 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $39 | $119 | $199 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $70 | $288 | $505 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $8 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $19 | $19 | $19 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $17 | $17 | $17 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $128 | $128 | $128 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $32 | $32 | $32 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $15 | $15 | $15 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $177 | $177 | $177 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $49 | $49 | $49 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $559 | $559 | $559 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $429 | $429 | $429 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,302 | $1,302 | $1,302 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $932 | $932 | $932 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $388 | $388 | $388 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $426 | $1,125 | $1,619 |
| Septoplasty CPT 30520 • ENT | $553 | $1,569 | $2,303 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $226 | $570 | $838 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $195 | $526 | $766 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $362 | $799 | $1,081 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $344 | $775 | $1,026 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $510 | $1,142 | $1,506 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $248 | $561 | $743 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $402 | $904 | $1,195 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $644 | $1,440 | $1,901 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $189 | $479 | $708 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $325 | $782 | $1,096 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $352 | $820 | $1,137 |
| Tonsillectomy primary under age 12 CPT 42826 • ENT | $289 | $680 | $948 |