| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $113 | $125 | $137 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $136 | $225 | $402 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $38 | $82 | $148 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $102 | $194 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $60 | $161 | $326 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $74 | $138 | $182 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $71 | $116 | $174 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $126 | $305 | $463 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $264 | $311 | $358 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $97 | $179 | $327 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $231 | $433 | $636 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $182 | $244 | $306 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $213 | $300 | $475 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $249 | $435 | $621 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $82 | $191 | $329 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $70 | $147 | $217 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $8 | $23 | $38 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $150 | $323 | $508 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $80 | $115 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $115 | $161 | $254 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $77 | $85 | $103 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $189 | $516 | $843 |
| 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 | $7 | $31 | $52 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $44 | $59 | $74 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $100 | $100 | $100 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $21 | $21 | $21 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $11 | $11 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $146 | $146 | $146 |
| 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 | $276 | $276 | $276 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $197 | $224 | $251 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $791 | $847 | $904 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $427 | $427 | $427 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $178 | $195 | $203 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $429 | $531 | $735 |
| Septoplasty CPT 30520 • ENT | $552 | $820 | $1,088 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $310 | $523 | $736 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $190 | $278 | $450 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $321 | $502 | $823 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $344 | $554 | $763 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $391 | $636 | $1,127 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $193 | $312 | $550 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $310 | $534 | $892 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $492 | $1,060 | $1,423 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $173 | $351 | $449 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $264 | $443 | $740 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $275 | $475 | $799 |