| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $16 | $61 | $106 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $99 | $116 | $132 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $3 | $44 | $85 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $103 | $103 | $103 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $16 | $24 | $32 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $49 | $49 | $49 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $77 | $77 | $77 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $13 | $13 | $13 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $149 | $149 | $149 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $18 | $70 | $122 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $128 | $128 | $128 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $13 | $13 | $13 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $141 | $141 | $141 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $26 | $26 | $26 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $46 | $46 | $46 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $5 | $5 | $5 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $1 | $1 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $86 | $114 | $143 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $20 | $20 | $20 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $11 | $11 | $11 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $21 | $64 | $106 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $64 | $96 | $128 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $4 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $53 | $61 | $70 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $44 | $44 | $44 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $573 | $573 | $574 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $16 | $90 | $163 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $29 | $53 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $73 | $399 | $726 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $4,429 | $5,167 | $5,905 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $211 | $211 | $211 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,920 | $2,240 | $2,561 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $107 | $160 | $213 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $34 | $34 | $34 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $65 | $65 | $65 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $74 | $110 | $147 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $326 | $326 | $326 |
| Septoplasty CPT 30520 • ENT | $111 | $111 | $111 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $83 | $83 | $83 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $31 | $120 | $208 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $146 | $218 | $291 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $96 | $289 | $481 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $355 | $355 | $355 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $20 | $110 | $199 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $219 | $219 | $219 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $311 | $311 | $311 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $89 | $108 | $127 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $136 | $136 | $136 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $142 | $213 | $284 |