| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $102 | $139 | $177 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $214 | $261 | $308 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $100 | $136 | $202 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $111 | $159 | $246 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $213 | $213 | $213 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $269 | $269 | $269 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $125 | $146 | $167 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $310 | $310 | $310 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $270 | $270 | $270 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $325 | $325 | $325 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $219 | $234 | $249 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $305 | $305 | $305 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $251 | $371 | $577 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $473 | $473 | $473 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $79 | $152 | $225 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $65 | $89 | $132 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $6 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $368 | $368 | $368 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $110 | $164 | $259 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $136 | $197 | $305 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $137 | $172 | $207 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $185 | $240 | $296 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $6 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $44 | $104 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $38 | $56 | $74 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $371 | $692 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $126 | $239 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $40 | $75 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $93 | $124 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $5,665 | $10,758 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $27 | $35 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $216 | $2,757 | $4,027 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $249 | $288 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $823 | $823 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $58 | $257 | $456 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $190 | $218 | $233 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $357 | $435 | $524 |
| Septoplasty CPT 30520 • ENT | $730 | $1,124 | $1,517 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $265 | $384 | $504 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $237 | $342 | $447 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $328 | $372 | $415 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $366 | $611 | $857 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $540 | $607 | $674 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $213 | $285 | $430 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $427 | $489 | $551 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $904 | $904 | $904 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $252 | $285 | $318 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $373 | $484 | $595 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $713 | $713 | $713 |