| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $141 | $166 | $190 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $172 | $201 | $230 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $106 | $121 | $151 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $89 | $148 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $128 | $128 | $128 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $56 | $56 | $56 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $101 | $101 | $101 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $189 | $189 | $189 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $208 | $208 | $208 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $157 | $165 | $173 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $135 | $239 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $277 | $277 | $277 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $223 | $382 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $48 | $147 | $246 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $163 | $163 | $163 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $66 | $66 | $66 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $5 | $8 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $222 | $222 | $222 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $83 | $137 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $123 | $203 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $140 | $157 | $173 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $78 | $136 | $195 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $11 | $41 | $62 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $32 | $40 | $47 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $60 | $342 | $623 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $23 | $86 | $150 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $6 | $6 | $6 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $73 | $454 | $836 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $710 | $3,758 | $6,805 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $22 | $23 | $24 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,656 | $2,382 | $2,744 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $185 | $193 | $202 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $611 | $611 | $611 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $331 | $367 | $403 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $163 | $166 | $168 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $239 | $409 |
| Septoplasty CPT 30520 • ENT | $30 | $428 | $826 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $266 | $266 | $266 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $176 | $322 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $171 | $312 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $30 | $327 | $623 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $266 | $502 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $219 | $239 | $249 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $411 | $411 | $411 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $308 | $586 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $235 | $248 | $262 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $193 | $356 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $373 | $373 | $373 |