| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $119 | $174 | $201 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $144 | $197 | $245 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $35 | $113 | $159 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $115 | $155 | $193 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $99 | $135 | $168 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $47 | $114 | $183 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $120 | $143 | $199 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $102 | $163 | $243 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $30 | $153 | $268 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $101 | $149 | $223 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $118 | $263 | $312 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $221 | $268 | $360 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $240 | $348 | $384 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $123 | $254 | $320 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $79 | $113 | $181 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $63 | $83 | $102 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $12 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $94 | $165 | $256 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $106 | $141 | $175 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $82 | $175 | $205 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $109 | $109 | $109 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $158 | $220 | $251 |
| 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 | $8 | $8 | $8 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $61 | $61 | $61 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $14 | $14 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $54 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $81 | $81 | $81 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $722 | $722 | $722 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $23 | $23 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,787 | $1,787 | $1,787 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $315 | $369 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $815 | $949 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $452 | $452 | $452 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $188 | $188 | $188 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $270 | $371 | $461 |
| Septoplasty CPT 30520 • ENT | $614 | $903 | $1,047 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $214 | $214 | $214 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $62 | $215 | $303 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $247 | $323 | $398 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $401 | $421 | $432 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $317 | $319 | $320 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $178 | $178 | $178 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $259 | $299 | $413 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $375 | $375 | $375 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $184 | $184 | $184 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $284 | $367 | $451 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $273 | $471 |