| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $39 | $169 | $299 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $362 | $362 | $362 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $85 | $85 | $85 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $128 | $128 | $128 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $251 | $251 | $251 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $275 | $275 | $275 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $142 | $169 | $196 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $100 | $232 | $365 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $118 | $261 | $405 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $333 | $333 | $333 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $470 | $470 | $470 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $210 | $379 | $548 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $226 | $347 | $590 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $484 | $484 | $484 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $73 | $104 | $135 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $41 | $85 | $129 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $10 | $12 | $14 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $377 | $377 | $377 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $74 | $164 | $265 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $312 | $312 | $312 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $266 | $266 | $266 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $380 | $380 | $380 |
| 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 | $28 | $28 | $28 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $49 | $49 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $12 | $12 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $5 | $5 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $63 | $63 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $573 | $573 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $19 | $19 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,438 | $1,438 | $1,438 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $210 | $210 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $823 | $823 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $456 | $456 | $456 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $190 | $190 | $190 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $370 | $591 | $725 |
| Septoplasty CPT 30520 • ENT | $1,552 | $1,605 | $1,658 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $515 | $525 | $536 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $155 | $307 | $458 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $606 | $615 | $623 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $594 | $835 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $790 | $791 | $793 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $437 | $438 | $440 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $646 | $647 | $648 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $921 | $923 | $925 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $458 | $463 | $469 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $700 | $704 | $709 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $730 | $735 | $740 |