| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $138 | $169 | $201 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $243 | $243 | $243 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $89 | $110 | $131 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $73 | $117 | $161 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $91 | $113 | $133 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $110 | $110 | $110 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $138 | $156 | $167 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $191 | $197 | $200 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $187 | $200 | $212 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $182 | $182 | $182 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $150 | $150 | $150 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $282 | $282 | $282 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $276 | $304 | $332 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $251 | $251 | $251 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $69 | $110 | $133 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $60 | $73 | $89 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $16 | $38 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $38 | $144 | $202 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $81 | $126 | $149 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $105 | $142 | $176 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $47 | $47 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $148 | $148 | $148 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $28 | $28 | $28 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $9 | $9 | $9 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $44 | $44 | $44 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $59 | $102 | $145 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $105 | $143 | $181 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $24 | $32 | $41 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $12 | $33 | $43 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $149 | $314 | $549 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,287 | $1,287 | $1,287 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $18 | $80 | $182 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $780 | $1,931 | $2,961 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $220 | $340 | $460 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $968 | $1,161 | $1,355 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $477 | $477 | $477 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $183 | $259 | $396 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $563 | $563 | $563 |
| Septoplasty CPT 30520 • ENT | $789 | $789 | $789 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $175 | $175 | $175 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $73 | $164 | $256 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $274 | $274 | $274 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $420 | $420 | $420 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $622 | $622 | $622 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $304 | $304 | $304 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $491 | $491 | $491 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $785 | $785 | $785 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $249 | $249 | $249 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $421 | $421 | $421 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $441 | $441 | $441 |