| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $72 | $147 | $222 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $210 | $243 | $275 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $76 | $127 | $178 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $65 | $78 | $90 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $65 | $72 | $79 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $45 | $56 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $90 | $120 | $150 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $169 | $179 | $188 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $86 | $112 | $137 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $127 | $147 | $167 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $91 | $146 | $202 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $232 | $251 | $271 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $218 | $246 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $205 | $223 | $241 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $94 | $105 | $115 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $41 | $61 | $80 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $9 | $14 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $73 | $151 | $229 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $115 | $159 | $202 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $132 | $145 | $158 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $43 | $91 | $140 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $74 | $75 | $76 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $11 | $19 | $27 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $6 | $9 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $6 | $25 | $45 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $17 | $30 | $44 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $56 | $84 | $112 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $24 | $95 | $165 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $12 | $13 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $70 | $115 | $160 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $750 | $1,062 | $1,373 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $37 | $130 | $222 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $262 | $316 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $225 | $239 | $254 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $742 | $888 | $1,033 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $330 | $409 | $488 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $203 | $212 | $221 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $314 | $405 | $496 |
| Septoplasty CPT 30520 • ENT | $506 | $575 | $644 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $114 | $188 | $263 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $114 | $170 | $227 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $192 | $226 | $260 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $180 | $290 | $401 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $568 | $581 | $595 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $289 | $303 | $317 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $311 | $390 | $469 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $279 | $515 | $751 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $144 | $182 | $220 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $379 | $450 | $522 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $410 | $477 | $545 |