| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $88 | $105 | $138 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $65 | $65 | $65 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $38 | $59 | $69 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $84 | $131 | $176 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $115 | $115 | $115 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $80 | $96 | $127 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $90 | $90 | $90 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $114 | $124 | $129 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $96 | $126 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $153 | $153 | $153 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $217 | $217 | $217 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $252 | $252 | $252 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $159 | $271 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $223 | $223 | $223 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $44 | $88 | $116 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $44 | $65 | $96 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $4 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $117 | $136 | $173 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $44 | $89 | $161 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $110 | $144 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $127 | $127 | $127 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $178 | $178 | $178 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $34 | $34 | $34 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $26 | $57 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $47 | $47 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $13 | $14 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $27 | $38 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $73 | $79 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $525 | $525 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $17 | $17 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,385 | $1,385 | $1,385 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $208 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $630 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $342 | $342 | $342 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $169 | $247 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $312 | $312 | $312 |
| Septoplasty CPT 30520 • ENT | $712 | $712 | $712 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $239 | $239 | $239 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $70 | $113 | $156 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $175 | $252 | $329 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $463 | $463 | $463 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $360 | $360 | $360 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $200 | $200 | $200 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $294 | $294 | $294 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $419 | $419 | $419 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $211 | $211 | $211 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $319 | $319 | $319 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $333 | $333 | $333 |