| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $67 | $154 | $269 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $94 | $200 | $326 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $67 | $139 | $251 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $145 | $164 | $184 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $152 | $157 | $162 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $107 | $146 | $174 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $148 | $180 | $213 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $118 | $166 | $202 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $71 | $134 | $177 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $112 | $150 | $205 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $177 | $234 | $294 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $173 | $203 | $233 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $152 | $250 | $380 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $186 | $219 | $251 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $74 | $97 | $134 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $44 | $76 | $101 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $36 | $102 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $209 | $221 | $230 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $75 | $119 | $169 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $87 | $163 | $202 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $117 | $141 | $165 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $99 | $194 | $260 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $50 | $50 | $50 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $9 | $9 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $58 | $58 | $58 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $78 | $78 | $78 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $27 | $27 | $27 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $16 | $24 | $33 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $109 | $109 | $109 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $573 | $573 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $81 | $81 | $81 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $6,068 | $6,068 | $6,068 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $161 | $161 | $161 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $865 | $955 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $350 | $350 | $350 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $268 | $268 | $268 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $112 | $769 | $1,417 |
| Septoplasty CPT 30520 • ENT | $780 | $842 | $954 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $129 | $238 | $347 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $69 | $351 | $666 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $393 | $419 | $470 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $426 | $540 | $653 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $407 | $497 | $624 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $308 | $480 | $651 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $250 | $433 | $685 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $788 | $1,227 | $1,667 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $168 | $318 | $510 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $318 | $377 | $452 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $471 | $472 | $473 |