| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $116 | $166 | $215 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $140 | $140 | $140 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $32 | $62 | $74 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $112 | $138 | $163 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $27 | $32 | $37 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $107 | $131 | $156 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $93 | $125 | $166 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $77 | $140 | $202 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $114 | $136 | $157 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $129 | $129 | $129 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $112 | $112 | $112 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $108 | $160 | $212 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $179 | $228 | $278 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $187 | $187 | $187 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $102 | $102 | $102 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $39 | $59 | $88 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $4 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $91 | $150 | $209 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $103 | $125 | $147 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $76 | $87 | $97 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $107 | $107 | $107 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $150 | $150 | $150 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $6 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $4 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $29 | $60 | $76 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $29 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $278 | $516 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $96 | $182 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $6 | $7 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $51 | $72 | $93 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $437 | $4,150 | $7,863 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $146 | $278 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,154 | $2,439 | $3,082 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $174 | $174 | $174 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $525 | $525 | $525 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $285 | $322 | $359 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $141 | $169 | $197 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $262 | $278 | $293 |
| Septoplasty CPT 30520 • ENT | $599 | $599 | $599 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $133 | $133 | $133 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $178 | $178 | $178 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $147 | $147 | $147 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $389 | $389 | $389 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $302 | $302 | $302 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $168 | $174 | $177 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $247 | $254 | $260 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $353 | $353 | $353 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $177 | $178 | $179 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $268 | $268 | $268 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $280 | $281 | $283 |