| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $119 | $133 | $157 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $145 | $164 | $184 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $99 | $145 | $237 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $128 | $136 | $154 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $61 | $138 | $251 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $114 | $119 | $122 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $91 | $156 | $196 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $148 | $203 | $250 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $80 | $133 | $186 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $175 | $254 | $333 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $195 | $223 | $251 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $199 | $373 | $548 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $163 | $279 | $337 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $166 | $325 | $484 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $75 | $132 | $172 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $77 | $114 | $156 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $8 | $11 | $14 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $133 | $185 | $237 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $68 | $112 | $148 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $127 | $170 | $200 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $59 | $59 | $59 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $159 | $159 | $159 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $10 | $26 | $41 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $5 | $5 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $105 | $105 | $105 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $23 | $23 | $23 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $12 | $12 | $12 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $150 | $150 | $150 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,287 | $1,287 | $1,287 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $19 | $19 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,438 | $1,694 | $1,950 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $211 | $211 | $211 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $968 | $968 | $968 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $458 | $503 | $548 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $190 | $209 | $228 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $628 | $645 | $680 |
| Septoplasty CPT 30520 • ENT | $876 | $1,214 | $1,552 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $178 | $347 | $515 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $86 | $278 | $458 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $439 | $518 | $606 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $468 | $531 | $594 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $573 | $654 | $694 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $339 | $372 | $440 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $263 | $452 | $547 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $374 | $712 | $875 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $212 | $315 | $458 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $407 | $510 | $700 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $402 | $512 | $730 |