| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $184 | $192 | $200 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $100 | $161 | $222 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $33 | $62 | $90 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $111 | $116 | $121 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $42 | $47 | $52 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $59 | $81 | $104 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $42 | $100 | $158 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $186 | $188 | $190 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $145 | $157 | $168 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $176 | $180 | $184 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $148 | $185 | $222 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $175 | $230 | $286 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $270 | $325 | $394 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $159 | $192 | $226 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $94 | $113 | $131 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $88 | $95 | $102 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $6 | $10 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $185 | $212 | $239 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $127 | $130 | $134 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $107 | $126 | $145 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $86 | $86 | $86 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $234 | $234 | $234 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $23 | $23 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $8 | $8 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $52 | $52 | $52 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $15 | $92 | $168 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $98 | $98 | $98 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $22 | $22 | $22 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $11 | $11 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $140 | $140 | $140 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,202 | $1,202 | $1,202 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $33 | $33 | $33 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,764 | $2,764 | $2,764 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $211 | $211 | $211 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $904 | $904 | $904 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $458 | $458 | $458 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $191 | $191 | $191 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $42 | $308 | $574 |
| Septoplasty CPT 30520 • ENT | $772 | $786 | $799 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $42 | $171 | $301 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $259 | $266 | $272 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $455 | $480 | $506 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $401 | $441 | $481 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $592 | $653 | $714 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $291 | $319 | $347 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $468 | $516 | $563 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $746 | $824 | $901 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $187 | $225 | $264 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $408 | $431 | $454 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $428 | $460 | $492 |