| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $53 | $139 | $201 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $89 | $181 | $271 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $48 | $124 | $207 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $142 | $226 | $279 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $60 | $126 | $230 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $130 | $212 | $264 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $125 | $179 | $265 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $170 | $215 | $262 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $117 | $216 | $357 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $142 | $155 | $166 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $189 | $246 | $318 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $243 | $307 | $371 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $102 | $336 | $576 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $172 | $225 | $278 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $70 | $95 | $117 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $56 | $89 | $130 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $18 | $36 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $237 | $307 | $359 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $73 | $100 | $131 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $134 | $192 | $304 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $110 | $150 | $191 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $274 | $275 | $276 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $6 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $15 | $50 | $86 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $12 | $51 | $90 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $50 | $73 | $96 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $24 | $28 | $31 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $12 | $15 | $18 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $65 | $98 | $130 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $573 | $573 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $21 | $28 | $36 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $420 | $508 | $596 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $316 | $330 | $345 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $955 | $972 | $989 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $431 | $605 | $699 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $291 | $325 | $373 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $167 | $513 | $1,016 |
| Septoplasty CPT 30520 • ENT | $709 | $838 | $1,025 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $271 | $281 | $291 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $81 | $222 | $481 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $294 | $448 | $599 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $617 | $645 | $672 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $407 | $718 | $992 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $184 | $366 | $467 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $250 | $441 | $751 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $706 | $1,050 | $1,250 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $168 | $327 | $444 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $361 | $470 | $685 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $475 | $581 | $714 |