| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $48 | $108 | $148 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $55 | $86 | $148 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $41 | $57 | $97 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $46 | $82 | $118 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $41 | $62 | $103 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $46 | $93 | $136 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $71 | $123 | $149 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $66 | $116 | $183 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $133 | $202 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $41 | $78 | $101 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $41 | $135 | $192 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $41 | $102 | $224 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $41 | $108 | $241 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $198 | $198 | $198 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $41 | $79 | $108 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $57 | $66 | $78 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $6 | $8 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $41 | $106 | $154 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $41 | $85 | $132 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $41 | $77 | $112 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $73 | $86 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $64 | $140 | $177 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $4 | $4 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $23 | $33 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $22 | $37 | $44 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $39 | $39 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $12 | $13 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $4 | $4 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $51 | $57 | $60 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $437 | $437 | $437 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $14 | $14 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,154 | $1,154 | $1,154 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $174 | $225 | $251 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $525 | $702 | $791 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $285 | $369 | $411 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $141 | $182 | $203 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $175 | $335 | $415 |
| Septoplasty CPT 30520 • ENT | $558 | $585 | $632 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $128 | $186 | $219 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $41 | $99 | $188 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $156 | $287 | $329 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $239 | $247 | $251 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $41 | $134 | $319 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $41 | $133 | $182 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $261 | $281 | $291 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $41 | $292 | $463 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $133 | $169 | $187 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $41 | $202 | $283 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $292 | $293 | $296 |