| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $46 | $98 | $149 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $136 | $158 | $181 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $33 | $44 | $55 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $76 | $81 | $87 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $56 | $62 | $68 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $37 | $59 | $81 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $78 | $86 | $95 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $117 | $131 | $145 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $130 | $148 | $166 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $82 | $112 | $143 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $103 | $126 | $148 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $137 | $159 | $182 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $199 | $205 | $211 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $157 | $166 | $176 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $79 | $89 | $99 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $46 | $58 | $69 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $9 | $12 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $114 | $170 | $227 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $60 | $75 | $89 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $77 | $92 | $106 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $39 | $47 | $55 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $70 | $107 | $144 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $21 | $21 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $7 | $7 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $9 | $9 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $12 | $12 | $12 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $76 | $76 | $76 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $17 | $17 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $10 | $10 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $104 | $104 | $104 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $932 | $932 | $932 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $29 | $29 | $29 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,185 | $2,185 | $2,185 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $190 | $190 | $190 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $774 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $412 | $412 | $412 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $172 | $172 | $172 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $354 | $390 | $426 |
| Septoplasty CPT 30520 • ENT | $509 | $531 | $553 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $133 | $157 | $181 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $66 | $130 | $195 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $269 | $315 | $362 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $240 | $292 | $344 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $352 | $431 | $510 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $173 | $211 | $248 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $279 | $341 | $402 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $445 | $544 | $644 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $155 | $172 | $189 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $250 | $287 | $325 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $260 | $306 | $352 |