| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $49 | $102 | $156 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $147 | $168 | $188 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $34 | $65 | $96 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $90 | $104 | $118 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $39 | $43 | $46 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $46 | $48 | $50 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $81 | $101 | $121 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $102 | $104 | $106 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $123 | $144 | $165 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $135 | $142 | $149 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $119 | $150 | $180 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $142 | $182 | $223 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $220 | $230 | $240 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $123 | $153 | $183 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $103 | $105 | $107 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $53 | $58 | $63 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $7 | $12 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $153 | $179 | $206 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $103 | $105 | $108 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $118 | $123 | $127 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $41 | $75 | $110 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $66 | $70 | $74 |
| 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 | $9 | $9 | $9 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $28 | $28 | $28 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $49 | $49 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $12 | $12 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $5 | $5 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $63 | $63 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $573 | $573 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $19 | $19 |
| 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 | $190 | $190 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $276 | $360 | $444 |
| Septoplasty CPT 30520 • ENT | $576 | $603 | $631 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $139 | $174 | $209 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $186 | $194 | $203 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $157 | $194 | $232 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $241 | $300 | $358 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $322 | $427 | $531 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $179 | $219 | $259 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $263 | $341 | $419 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $376 | $523 | $671 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $155 | $171 | $186 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $284 | $311 | $338 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $297 | $332 | $367 |