| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $62 | $138 | $167 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $55 | $154 | $205 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $100 | $116 | $133 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $72 | $137 | $161 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $54 | $54 | $54 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $154 | $154 | $154 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $168 | $168 | $168 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $102 | $153 | $205 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $30 | $92 | $227 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $187 | $187 | $187 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $264 | $264 | $264 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $144 | $251 | $307 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $331 | $331 | $331 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $271 | $271 | $271 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $37 | $107 | $172 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $64 | $87 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $7 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $90 | $211 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $110 | $136 | $151 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $129 | $200 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $152 | $152 | $152 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $217 | $217 | $217 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $3 | $3 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $1 | $1 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $35 | $35 | $35 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $19 | $19 | $19 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $33 | $33 | $33 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $8 | $8 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $4 | $4 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $42 | $42 | $42 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $382 | $382 | $382 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $13 | $13 | $13 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $144 | $144 | $144 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $140 | $140 | $140 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $548 | $548 | $548 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $304 | $304 | $304 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $127 | $127 | $127 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $268 | $392 |
| Septoplasty CPT 30520 • ENT | $30 | $600 | $900 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $289 | $289 | $289 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $86 | $209 | $257 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $287 | $439 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $565 | $565 | $565 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $317 | $397 | $444 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $30 | $172 | $247 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $259 | $310 | $363 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $370 | $441 | $519 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $158 | $257 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $285 | $369 | $407 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $409 | $413 | $425 |