| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $62 | $113 | $140 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $67 | $116 | $166 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $39 | $85 | $108 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $45 | $59 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $118 | $118 | $118 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $45 | $87 | $129 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $140 | $140 | $140 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $65 | $118 | $171 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $175 | $182 | $190 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $156 | $156 | $156 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $125 | $221 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $167 | $167 | $167 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $178 | $276 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $141 | $141 | $141 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $62 | $98 | $134 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $56 | $65 | $73 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $3 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $176 | $177 | $177 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $76 | $125 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $105 | $146 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $120 | $124 | $129 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $173 | $177 | $182 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $11 | $27 | $56 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $35 | $42 | $49 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $62 | $287 | $512 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $68 | $121 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $6 | $7 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $82 | $316 | $549 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $730 | $2,947 | $5,165 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $26 | $129 | $232 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,615 | $2,053 | $2,736 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $212 | $213 | $214 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $630 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $33 | $215 | $397 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $15 | $127 | $184 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $107 | $201 |
| Septoplasty CPT 30520 • ENT | $30 | $512 | $780 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $243 | $260 | $277 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $61 | $81 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $204 | $299 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $30 | $251 | $471 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $268 | $407 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $203 | $209 | $212 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $165 | $299 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $228 | $426 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $152 | $185 | $236 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $238 | $361 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $339 | $339 | $339 |