| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $123 | $183 | $243 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $165 | $229 | $294 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $99 | $127 | $185 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $130 | $163 | $228 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $102 | $131 | $190 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $122 | $153 | $217 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $180 | $199 | $237 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $213 | $237 | $287 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $164 | $241 | $319 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $22 | $141 | $261 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $372 | $372 | $372 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $295 | $295 | $295 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $337 | $384 | $478 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $387 | $387 | $387 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $99 | $116 | $144 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $77 | $110 | $145 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $8 | $13 | $19 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $22 | $155 | $289 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $148 | $169 | $211 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $176 | $201 | $251 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $128 | $128 | $128 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $289 | $289 | $289 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $22 | $22 | $22 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $8 | $8 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $57 | $57 | $57 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $14 | $14 | $14 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $93 | $93 | $93 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $21 | $21 | $21 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $12 | $12 | $12 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $125 | $125 | $125 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,132 | $1,132 | $1,132 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $36 | $36 | $36 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $398 | $398 | $398 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $231 | $231 | $231 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $904 | $904 | $904 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $500 | $500 | $500 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $208 | $208 | $208 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $628 | $708 | $869 |
| Septoplasty CPT 30520 • ENT | $876 | $1,058 | $1,241 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $22 | $234 | $447 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $285 | $326 | $408 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $511 | $513 | $514 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $468 | $510 | $552 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $694 | $732 | $809 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $339 | $359 | $399 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $547 | $579 | $642 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $370 | $755 | $1,022 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $276 | $276 | $277 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $467 | $508 | $589 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $491 | $531 | $612 |