| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $88 | $102 | $123 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $117 | $140 | $153 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $73 | $159 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $70 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $55 | $81 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $73 | $110 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $75 | $120 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $117 | $279 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $119 | $164 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $55 | $79 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $113 | $193 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $218 | $218 | $218 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $239 | $384 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $122 | $247 | $372 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $65 | $105 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $49 | $65 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $14 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $130 | $280 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $82 | $109 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $79 | $126 | $205 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $112 | $144 | $207 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $152 | $153 | $155 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $6 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $27 | $58 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $16 | $47 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $283 | $518 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $91 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $23 | $53 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $79 | $551 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $283 | $545 | $807 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $27 | $123 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $139 | $2,074 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $288 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $420 | $420 | $420 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $452 | $683 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $169 | $280 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $197 | $291 |
| Septoplasty CPT 30520 • ENT | $498 | $581 | $665 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $145 | $145 | $145 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $91 | $183 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $175 | $250 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $415 | $423 | $431 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $217 | $317 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $140 | $163 | $175 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $140 | $250 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $197 | $364 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $63 | $130 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $285 | $542 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $131 | $233 |