| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $108 | $134 | $160 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $134 | $139 | $145 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $34 | $69 | $87 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $78 | $95 | $113 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $31 | $45 | $59 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $71 | $71 | $71 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $97 | $97 | $97 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $119 | $119 | $119 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $94 | $126 | $158 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $82 | $82 | $82 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $95 | $132 | $170 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $125 | $154 | $184 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $177 | $220 | $272 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $159 | $167 | $175 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $113 | $273 | $433 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $46 | $70 | $94 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $5 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $116 | $116 | $116 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $76 | $105 | $135 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $116 | $137 | $153 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $59 | $90 | $121 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $151 | $155 | $159 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $19 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $47 | $65 | $74 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $70 | $81 | $92 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $127 | $491 | $855 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $24 | $118 | $211 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $17 | $60 | $103 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $149 | $666 | $1,182 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,320 | $5,682 | $10,044 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $49 | $203 | $358 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $3,095 | $3,520 | $3,733 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $285 | $299 | $314 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,038 | $1,038 | $1,038 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $468 | $499 | $530 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $242 | $255 | $262 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $256 | $332 | $483 |
| Septoplasty CPT 30520 • ENT | $586 | $630 | $674 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $112 | $112 | $112 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $159 | $169 | $179 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $222 | $297 | $371 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $250 | $313 | $377 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $270 | $383 | $497 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $151 | $182 | $243 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $222 | $307 | $391 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $626 | $626 | $626 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $117 | $143 | $168 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $251 | $294 | $337 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $353 | $353 | $353 |