| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $88 | $93 | $103 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $125 | $125 | $125 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $29 | $82 | $159 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $84 | $124 | $176 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $87 | $87 | $87 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $80 | $85 | $95 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $68 | $68 | $68 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $86 | $115 | $129 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $86 | $95 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $86 | $86 | $86 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $101 | $101 | $101 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $189 | $189 | $189 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $199 | $384 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $105 | $105 | $105 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $44 | $85 | $116 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $54 | $73 | $96 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $5 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $117 | $122 | $130 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $44 | $80 | $161 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $68 | $115 | $205 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $93 | $93 | $93 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $56 | $56 | $56 |
| 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 | $52 | $52 | $52 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $38 | $61 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $73 | $96 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $19 | $31 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $19 | $38 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $105 | $173 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $573 | $573 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $28 | $37 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,438 | $1,438 | $1,438 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $210 | $210 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $823 | $823 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $456 | $456 | $456 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $190 | $254 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $235 | $701 | $1,406 |
| Septoplasty CPT 30520 • ENT | $469 | $502 | $536 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $178 | $178 | $178 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $156 | $157 | $158 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $133 | $231 | $329 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $348 | $537 | $726 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $274 | $1,246 | $2,219 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $152 | $439 | $726 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $224 | $475 | $726 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $319 | $1,269 | $2,219 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $158 | $158 | $158 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $242 | $590 | $937 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $252 | $595 | $937 |