| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $100 | $218 | $336 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $123 | $138 | $152 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $81 | $144 | $271 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $327 | $380 | $434 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $102 | $219 | $336 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $313 | $347 | $382 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $225 | $250 | $275 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $419 | $461 | $504 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $461 | $510 | $560 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $284 | $370 | $456 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $530 | $614 | $699 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $398 | $615 | $832 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $583 | $902 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $545 | $611 | $678 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $309 | $324 | $338 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $180 | $181 | $183 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $12 | $19 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $345 | $399 | $452 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $304 | $352 | $401 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $104 | $267 | $476 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $92 | $201 | $310 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $122 | $270 | $418 |
| 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 | $55 | $64 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $6 | $6 | $6 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $52 | $52 | $52 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $13 | $13 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $6 | $34 | $63 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $69 | $69 | $69 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $604 | $604 | $604 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $20 | $20 | $20 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $228 | $228 | $228 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $215 | $218 | $220 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $498 | $537 | $576 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $318 | $371 | $478 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $177 | $184 | $199 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $305 | $908 | $1,619 |
| Septoplasty CPT 30520 • ENT | $1,831 | $2,067 | $2,303 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $589 | $713 | $838 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $174 | $470 | $766 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $691 | $822 | $954 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $1,026 | $1,104 | $1,182 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $872 | $1,189 | $1,506 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $178 | $280 | $485 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $715 | $914 | $1,113 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $1,018 | $1,394 | $1,771 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $192 | $457 | $659 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $789 | $943 | $1,096 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $826 | $943 | $1,060 |