| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $49 | $93 | $115 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $142 | $145 | $153 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $62 | $92 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $92 | $114 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $63 | $97 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $72 | $108 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $74 | $118 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $92 | $144 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $111 | $134 | $158 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $97 | $132 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $144 | $184 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $30 | $153 | $219 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $226 | $229 | $237 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $187 | $189 | $192 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $77 | $106 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $52 | $64 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $11 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $123 | $163 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $76 | $103 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $79 | $112 | $125 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $67 | $99 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $149 | $150 | $150 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $9 | $19 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $8 | $37 | $59 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $33 | $33 | $33 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $60 | $337 | $518 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $124 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $52 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $78 | $628 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $704 | $3,605 | $5,055 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $124 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,750 | $2,151 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $200 | $211 | $216 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $565 | $674 | $783 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $434 | $567 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $181 | $193 | $202 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $253 | $426 |
| Septoplasty CPT 30520 • ENT | $606 | $625 | $635 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $201 | $211 | $220 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $144 | $202 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $190 | $251 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $270 | $363 | $409 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $261 | $396 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $171 | $179 | $196 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $157 | $314 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $230 | $500 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $134 | $198 | $231 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $258 | $357 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $234 | $374 |