| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $53 | $116 | $168 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $59 | $150 | $236 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $35 | $142 | $226 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $69 | $132 | $203 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $60 | $119 | $168 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $144 | $168 | $193 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $44 | $121 | $209 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $65 | $171 | $252 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $71 | $135 | $201 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $186 | $210 | $227 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $140 | $168 | $196 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $299 | $415 | $531 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $102 | $312 | $576 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $202 | $232 | $263 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $61 | $98 | $178 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $56 | $89 | $113 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $28 | $55 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $209 | $292 | $359 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $85 | $134 | $186 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $133 | $204 | $304 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $133 | $138 | $143 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $175 | $177 | $178 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $4 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $13 | $48 | $66 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $26 | $35 | $45 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $58 | $197 | $336 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $143 | $149 | $155 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $28 | $47 | $65 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $36 | $416 | $795 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $315 | $3,504 | $6,694 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $173 | $202 | $230 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $262 | $1,270 | $2,624 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $152 | $264 | $377 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $486 | $612 | $739 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $357 | $545 | $686 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $226 | $250 | $263 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $167 | $403 | $741 |
| Septoplasty CPT 30520 • ENT | $726 | $768 | $798 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $64 | $176 | $288 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $85 | $221 | $351 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $274 | $344 | $455 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $470 | $519 | $568 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $330 | $445 | $691 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $197 | $377 | $467 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $250 | $386 | $548 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $512 | $692 | $871 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $64 | $233 | $444 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $277 | $380 | $500 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $401 | $466 | $521 |