| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $49 | $90 | $157 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $78 | $111 | $144 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $32 | $33 | $35 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $53 | $99 | $154 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $42 | $68 | $95 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $46 | $77 | $108 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $78 | $98 | $118 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $142 | $145 | $147 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $80 | $134 | $163 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $100 | $101 | $103 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $115 | $116 | $116 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $146 | $146 | $147 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $233 | $235 | $237 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $122 | $157 | $193 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $96 | $122 | $172 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $64 | $69 | $75 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $4 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $144 | $146 | $148 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $68 | $85 | $102 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $81 | $135 | $200 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $57 | $67 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $144 | $146 | $149 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $19 | $19 | $19 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $7 | $7 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $50 | $50 | $50 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $12 | $40 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $60 | $84 | $96 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $26 | $31 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $12 | $15 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $78 | $141 | $173 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $704 | $704 | $704 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $32 | $37 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $262 | $262 | $262 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $200 | $200 | $200 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $783 | $783 | $783 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $434 | $434 | $434 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $181 | $181 | $181 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $426 | $430 | $433 |
| Septoplasty CPT 30520 • ENT | $605 | $605 | $606 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $134 | $177 | $220 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $64 | $79 | $86 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $160 | $270 | $439 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $270 | $297 | $323 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $396 | $438 | $479 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $196 | $215 | $234 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $263 | $319 | $378 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $374 | $493 | $604 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $134 | $163 | $191 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $288 | $339 | $407 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $299 | $354 | $425 |