| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $154 | $226 | $299 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $61 | $69 | $77 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $36 | $124 | $237 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $61 | $95 | $128 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $43 | $147 | $251 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $49 | $72 | $95 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $131 | $215 | $299 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $116 | $143 | $169 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $128 | $267 | $405 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $113 | $134 | $155 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $133 | $133 | $134 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $171 | $265 | $359 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $189 | $339 | $590 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $142 | $223 | $304 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $67 | $166 | $265 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $60 | $75 | $90 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $5 | $8 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $158 | $267 | $377 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $75 | $77 | $78 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $98 | $142 | $198 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $69 | $98 | $126 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $75 | $122 | $168 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $3 | $3 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $31 | $52 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $23 | $23 | $23 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $194 | $194 | $194 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $57 | $57 | $57 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $5 | $5 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $253 | $253 | $253 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $334 | $334 | $334 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $12 | $12 | $12 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,438 | $2,240 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $164 | $164 | $164 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $823 | $823 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $357 | $578 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $149 | $241 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $291 | $366 | $488 |
| Septoplasty CPT 30520 • ENT | $704 | $719 | $734 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $151 | $247 | $343 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $92 | $146 | $201 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $220 | $413 | $606 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $334 | $403 | $471 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $349 | $420 | $491 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $204 | $241 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $389 | $518 | $648 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $409 | $514 | $620 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $188 | $243 | $325 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $348 | $524 | $700 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $362 | $546 | $730 |