| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $106 | $141 | $176 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $217 | $217 | $217 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $38 | $38 | $39 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $67 | $118 | $170 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $73 | $80 | $86 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $98 | $98 | $98 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $150 | $150 | $150 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $220 | $220 | $220 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $129 | $129 | $129 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $293 | $293 | $293 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $123 | $200 | $277 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $155 | $155 | $155 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $253 | $313 | $345 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $137 | $158 | $178 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $120 | $120 | $120 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $114 | $114 | $114 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $13 | $13 | $13 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $332 | $332 | $332 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $156 | $194 | $233 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $38 | $119 | $184 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $32 | $118 | $205 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $286 | $300 | $315 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $18 | $30 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $4 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $14 | $49 | $81 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $59 | $74 | $90 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $51 | $313 | $576 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $26 | $112 | $198 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $27 | $44 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $65 | $391 | $718 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,373 | $5,176 | $8,979 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $35 | $167 | $300 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,537 | $2,760 | $3,159 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $201 | $235 | $269 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $850 | $850 | $850 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $426 | $456 | $486 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $196 | $236 | $267 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $299 | $450 | $654 |
| Septoplasty CPT 30520 • ENT | $662 | $1,080 | $1,498 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $302 | $302 | $302 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $107 | $258 | $408 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $533 | $547 | $562 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $243 | $606 | $969 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $361 | $545 | $730 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $264 | $305 | $387 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $480 | $480 | $480 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $814 | $814 | $814 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $38 | $119 | $201 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $389 | $475 | $562 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $421 | $421 | $421 |