| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $95 | $140 | $184 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $115 | $169 | $222 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $28 | $35 | $42 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $42 | $76 | $111 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $31 | $59 | $87 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $42 | $65 | $88 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $96 | $97 | $99 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $117 | $123 | $130 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $42 | $66 | $90 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $106 | $145 | $184 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $150 | $186 | $222 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $117 | $146 | $175 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $128 | $199 | $270 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $42 | $70 | $99 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $84 | $105 | $126 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $42 | $46 | $50 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $10 | $15 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $42 | $80 | $117 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $85 | $106 | $127 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $101 | $123 | $145 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $87 | $87 | $87 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $126 | $126 | $126 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $52 | $52 | $52 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $47 | $47 | $47 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $61 | $61 | $61 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $14 | $14 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $7 | $7 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $81 | $81 | $81 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $722 | $722 | $722 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $23 | $23 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $268 | $268 | $268 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $208 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $815 | $815 | $815 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $452 | $452 | $452 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $188 | $188 | $188 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $42 | $129 | $216 |
| Septoplasty CPT 30520 • ENT | $491 | $632 | $772 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $171 | $243 | $316 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $154 | $213 | $272 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $126 | $316 | $506 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $321 | $401 | $481 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $256 | $485 | $714 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $143 | $245 | $347 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $210 | $386 | $563 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $300 | $600 | $901 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $147 | $206 | $264 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $227 | $341 | $454 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $236 | $364 | $492 |