| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $123 | $136 | $149 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $152 | $166 | $181 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $33 | $66 | $99 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $87 | $103 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $44 | $74 | $104 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $48 | $81 | $113 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $78 | $101 | $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 | $118 | $142 | $167 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $106 | $122 | $139 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $103 | $148 | $193 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $199 | $210 | $222 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $211 | $224 | $237 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $111 | $155 | $198 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $74 | $76 | $78 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $51 | $58 | $65 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $8 | $10 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $163 | $195 | $227 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $60 | $62 | $64 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $77 | $103 | $128 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $39 | $76 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $146 | $149 | $152 |
| 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 | $73 | $73 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $53 | $53 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $690 | $690 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $178 | $178 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $76 | $76 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $927 | $927 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $807 | $807 | $807 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $270 | $270 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $3,041 | $3,041 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $368 | $368 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,015 | $1,015 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $799 | $799 | $799 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $333 | $333 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $291 | $359 | $426 |
| Septoplasty CPT 30520 • ENT | $553 | $609 | $665 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $133 | $174 | $215 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $90 | $136 | $183 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $250 | $306 | $362 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $344 | $388 | $431 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $317 | $414 | $510 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $248 | $248 | $248 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $259 | $331 | $402 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $369 | $506 | $644 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $188 | $188 | $189 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $284 | $304 | $325 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $297 | $325 | $352 |