| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $73 | $118 | $163 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $199 | $208 | $217 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $39 | $85 | $108 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $104 | $130 | $156 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $52 | $52 | $52 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $57 | $57 | $57 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $91 | $92 | $93 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $102 | $174 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $187 | $193 | $199 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $172 | $176 | $181 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $208 | $208 | $208 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $239 | $247 | $255 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $174 | $174 | $174 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $211 | $211 | $211 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $99 | $109 | $118 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $56 | $83 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $10 | $14 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $236 | $236 | $236 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $119 | $131 | $142 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $136 | $136 | $136 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $52 | $52 | $52 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $92 | $92 | $92 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $30 | $30 | $30 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $8 | $8 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $62 | $62 | $62 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $36 | $63 | $90 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $46 | $79 | $112 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $26 | $74 | $121 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $13 | $23 | $32 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $160 | $355 | $549 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,373 | $1,373 | $1,373 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $43 | $90 | $136 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $316 | $316 | $316 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $229 | $229 | $229 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $791 | $791 | $791 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $394 | $410 | $426 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $197 | $197 | $197 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $371 | $418 | $512 |
| Septoplasty CPT 30520 • ENT | $662 | $752 | $842 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $160 | $160 | $160 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $107 | $177 | $247 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $320 | $377 | $434 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $411 | $480 | $549 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $398 | $503 | $609 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $203 | $234 | $296 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $300 | $390 | $480 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $465 | $617 | $768 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $212 | $228 | $244 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $359 | $374 | $389 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $375 | $398 | $421 |