| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $67 | $150 | $211 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $167 | $211 | $256 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $67 | $84 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $137 | $158 | $173 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $82 | $82 | $82 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $69 | $107 | $156 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $150 | $158 | $166 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $117 | $166 | $206 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $114 | $184 | $240 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $153 | $171 | $189 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $167 | $167 | $167 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $239 | $239 | $239 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $167 | $263 | $357 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $211 | $211 | $211 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $51 | $84 | $118 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $38 | $69 | $88 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $7 | $12 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $204 | $206 | $209 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $101 | $129 | $147 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $87 | $139 | $192 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $104 | $104 | $104 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $92 | $92 | $92 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $30 | $30 | $30 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $8 | $8 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $14 | $14 | $14 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $69 | $69 | $69 |
| 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 | $1,320 | $1,320 | $1,320 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $49 | $49 | $49 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $3,095 | $3,095 | $3,095 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $314 | $314 | $314 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $989 | $989 | $989 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $515 | $515 | $515 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $254 | $254 | $254 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $512 | $512 | $512 |
| Septoplasty CPT 30520 • ENT | $902 | $902 | $902 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $197 | $197 | $197 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $185 | $210 | $234 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $289 | $289 | $289 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $440 | $440 | $440 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $652 | $652 | $652 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $319 | $319 | $319 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $514 | $514 | $514 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $821 | $821 | $821 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $227 | $227 | $227 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $389 | $389 | $389 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $421 | $421 | $421 |