| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $93 | $125 | $157 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $112 | $134 | $155 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $70 | $91 | $101 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $53 | $134 | $197 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $55 | $103 | $151 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $55 | $70 | $86 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $148 | $241 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $157 | $229 | $301 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $55 | $120 | $177 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $104 | $104 | $104 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $95 | $95 | $95 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $465 | $465 | $465 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $245 | $282 | $356 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $152 | $152 | $152 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $83 | $123 | $172 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $41 | $54 | $67 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $30 | $55 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $76 | $76 | $76 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $111 | $129 | $147 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $97 | $148 | $200 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $71 | $71 | $71 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $147 | $147 | $147 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $18 | $18 | $18 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $46 | $46 | $46 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $137 | $137 | $137 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $62 | $62 | $62 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $15 | $15 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $7 | $7 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $82 | $82 | $82 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $730 | $730 | $730 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $83 | $83 | $83 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $5,406 | $5,406 | $5,406 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $214 | $214 | $214 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,468 | $1,468 | $1,468 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $397 | $397 | $397 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $184 | $184 | $184 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $144 | $214 | $309 |
| Septoplasty CPT 30520 • ENT | $496 | $602 | $707 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $281 | $281 | $281 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $86 | $223 | $392 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $127 | $277 | $439 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $197 | $327 | $457 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $263 | $306 | $350 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $192 | $292 | $490 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $215 | $254 | $285 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $55 | $567 | $1,271 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $202 | $268 | $400 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $228 | $317 | $407 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $55 | $239 | $425 |