| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $139 | $163 | $186 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $62 | $171 | $225 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $59 | $77 | $85 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $45 | $77 | $112 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $43 | $64 | $89 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $39 | $39 | $39 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $43 | $106 | $162 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $130 | $169 | $189 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $99 | $157 | $216 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $43 | $107 | $186 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $87 | $179 | $225 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $177 | $218 | $259 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $187 | $245 | $274 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $94 | $94 | $94 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $84 | $103 | $128 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $43 | $66 | $89 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $10 | $22 | $43 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $43 | $177 | $295 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $91 | $116 | $129 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $66 | $120 | $147 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $49 | $49 | $49 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $167 | $175 | $183 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $30 | $30 | $30 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $9 | $9 | $9 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $62 | $62 | $62 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $96 | $96 | $96 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $112 | $112 | $112 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $26 | $26 | $26 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $13 | $13 | $13 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $160 | $160 | $160 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,373 | $1,373 | $1,373 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $43 | $43 | $43 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $3,159 | $3,159 | $3,159 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $298 | $298 | $298 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $862 | $862 | $862 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $478 | $478 | $478 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $197 | $197 | $197 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $485 | $605 | $725 |
| Septoplasty CPT 30520 • ENT | $607 | $1,133 | $1,658 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $151 | $343 | $536 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $95 | $277 | $458 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $411 | $517 | $623 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $360 | $717 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $532 | $661 | $790 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $260 | $348 | $437 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $420 | $533 | $646 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $670 | $795 | $921 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $194 | $331 | $469 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $417 | $563 | $709 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $451 | $595 | $740 |