| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $35 | $88 | $141 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $123 | $243 | $362 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $63 | $75 | $81 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $47 | $72 | $96 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $32 | $36 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $77 | $84 | $92 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $100 | $148 | $196 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $122 | $244 | $365 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $134 | $270 | $405 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $81 | $207 | $333 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $293 | $293 | $293 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $199 | $199 | $199 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $323 | $590 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $304 | $304 | $304 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $38 | $151 | $265 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $52 | $61 | $71 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $6 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $74 | $225 | $377 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $89 | $125 | $161 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $104 | $107 | $114 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $62 | $77 | $92 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $64 | $64 | $64 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $10 | $10 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $52 | $52 | $52 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $18 | $18 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $140 | $140 | $140 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $12 | $12 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $16 | $16 | $16 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $199 | $199 | $199 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,459 | $1,459 | $1,459 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $19 | $19 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,438 | $1,438 | $1,438 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $299 | $299 | $299 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $498 | $660 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $318 | $364 | $456 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $177 | $181 | $190 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $305 | $488 | $725 |
| Septoplasty CPT 30520 • ENT | $554 | $1,106 | $1,658 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $212 | $374 | $536 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $155 | $307 | $458 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $606 | $615 | $623 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $594 | $835 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $410 | $600 | $790 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $178 | $265 | $440 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $646 | $647 | $648 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $516 | $718 | $921 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $132 | $295 | $458 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $282 | $496 | $709 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $296 | $518 | $740 |