| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $88 | $119 | $149 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $60 | $161 | $242 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $33 | $67 | $158 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $87 | $124 | $194 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $44 | $102 | $166 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $48 | $105 | $184 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $78 | $119 | $201 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $66 | $128 | $245 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $116 | $158 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $106 | $152 | $223 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $106 | $184 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $199 | $209 | $219 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $145 | $237 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $111 | $151 | $192 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $74 | $110 | $177 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $49 | $67 | $106 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $12 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $130 | $227 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $60 | $100 | $178 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $77 | $96 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $39 | $73 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $66 | $106 | $146 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $19 | $19 | $19 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $5 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $37 | $55 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $46 | $59 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $60 | $60 | $60 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $14 | $15 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $41 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $78 | $361 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $704 | $704 | $704 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $147 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,750 | $2,395 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $200 | $200 | $200 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $783 | $783 | $783 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $434 | $617 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $181 | $266 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $294 | $426 |
| Septoplasty CPT 30520 • ENT | $553 | $579 | $606 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $133 | $177 | $220 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $87 | $165 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $243 | $362 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $270 | $307 | $344 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $312 | $510 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $206 | $248 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $249 | $402 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $391 | $644 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $135 | $189 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $214 | $325 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $227 | $352 |