| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $88 | $112 | $124 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $62 | $122 | $153 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $25 | $56 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $47 | $84 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $32 | $33 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $49 | $80 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $65 | $99 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $92 | $129 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $88 | $109 | $131 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $81 | $112 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $51 | $92 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $173 | $173 | $173 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $87 | $186 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $98 | $148 | $198 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $52 | $95 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $44 | $60 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $12 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $89 | $119 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $79 | $109 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $87 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $43 | $89 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $133 | $143 | $152 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $13 | $18 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $4 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $31 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $53 | $61 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $77 | $384 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $70 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $50 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $79 | $302 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $807 | $876 | $944 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $26 | $166 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,172 | $2,498 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $161 | $265 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $710 | $710 | $710 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $350 | $650 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $146 | $274 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $159 | $416 |
| Septoplasty CPT 30520 • ENT | $30 | $305 | $581 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $30 | $125 | $220 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $48 | $83 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $134 | $341 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $30 | $170 | $310 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $173 | $460 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $192 | $225 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $217 | $363 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $326 | $580 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $83 | $188 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $126 | $318 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $182 | $333 |