| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $55 | $89 | $123 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $160 | $160 | $160 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $40 | $79 | $99 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $128 | $130 | $130 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $61 | $89 | $106 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $122 | $122 | $122 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $113 | $142 | $180 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $160 | $195 | $213 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $168 | $173 | $178 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $143 | $143 | $143 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $132 | $132 | $132 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $165 | $165 | $165 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $181 | $285 | $337 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $214 | $214 | $214 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $99 | $119 | $144 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $58 | $81 | $108 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $7 | $12 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $110 | $110 | $110 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $117 | $138 | $148 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $149 | $176 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $59 | $59 | $59 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $134 | $134 | $134 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $44 | $44 | $44 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $30 | $30 | $30 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $39 | $39 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $23 | $23 | $23 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $4 | $4 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $46 | $46 | $46 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $422 | $422 | $422 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $15 | $15 | $15 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,179 | $1,179 | $1,179 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $260 | $260 | $260 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $746 | $746 | $746 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $397 | $397 | $397 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $181 | $181 | $181 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $469 | $575 | $628 |
| Septoplasty CPT 30520 • ENT | $672 | $774 | $876 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $241 | $241 | $241 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $221 | $264 | $285 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $178 | $402 | $514 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $303 | $386 | $468 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $445 | $611 | $694 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $219 | $299 | $339 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $259 | $386 | $547 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $370 | $602 | $875 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $205 | $253 | $277 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $320 | $418 | $467 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $297 | $374 | $491 |