| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $155 | $175 | $195 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $78 | $157 | $237 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $57 | $62 | $68 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $54 | $119 | $184 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $70 | $112 | $153 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $84 | $129 | $175 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $124 | $157 | $190 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $102 | $133 | $164 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $163 | $172 | $181 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $140 | $152 | $164 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $115 | $207 | $299 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $216 | $285 | $354 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $233 | $309 | $385 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $123 | $217 | $312 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $84 | $92 | $100 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $75 | $79 | $83 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $8 | $12 | $15 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $148 | $190 | $233 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $102 | $136 | $169 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $122 | $162 | $202 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $72 | $97 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $62 | $140 | $218 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $25 | $25 | $25 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $9 | $9 | $9 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $65 | $65 | $65 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $80 | $80 | $80 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $106 | $106 | $106 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $24 | $24 | $24 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $14 | $14 | $14 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $143 | $143 | $143 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,294 | $1,294 | $1,294 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $41 | $41 | $41 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $3,034 | $3,034 | $3,034 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $264 | $264 | $264 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,033 | $1,033 | $1,033 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $572 | $572 | $572 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $238 | $238 | $238 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $433 | $566 | $699 |
| Septoplasty CPT 30520 • ENT | $605 | $801 | $998 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $229 | $294 | $360 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $86 | $207 | $328 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $210 | $311 | $411 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $323 | $384 | $444 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $479 | $565 | $651 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $234 | $278 | $321 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $378 | $447 | $516 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $604 | $713 | $822 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $146 | $227 | $307 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $323 | $398 | $474 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $339 | $415 | $492 |