| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $106 | $148 | $191 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $234 | $276 | $319 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $80 | $123 | $209 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $99 | $177 | $255 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $221 | $221 | $221 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $101 | $101 | $101 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $263 | $263 | $263 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $81 | $151 | $220 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $356 | $356 | $356 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $121 | $207 | $293 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $155 | $206 | $258 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $482 | $482 | $482 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $192 | $318 | $520 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $425 | $425 | $425 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $233 | $233 | $233 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $114 | $114 | $114 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $13 | $13 | $13 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $210 | $210 | $211 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $112 | $127 | $142 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $103 | $135 | $175 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $117 | $168 | $218 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $260 | $287 | $315 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $50 | $57 | $61 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $41 | $45 | $49 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $51 | $256 | $461 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $86 | $159 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $6 | $37 | $68 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $65 | $73 | $82 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $592 | $3,890 | $7,188 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $20 | $130 | $240 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $223 | $1,067 | $2,708 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $189 | $203 | $217 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $850 | $850 | $850 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $410 | $431 | $471 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $171 | $179 | $196 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $271 | $446 | $597 |
| Septoplasty CPT 30520 • ENT | $1,070 | $1,217 | $1,364 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $452 | $452 | $452 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $137 | $224 | $310 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $407 | $470 | $533 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $523 | $610 | $697 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $515 | $606 | $698 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $165 | $239 | $387 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $63 | $317 | $570 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $814 | $814 | $814 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $203 | $244 | $286 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $532 | $574 | $616 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $271 | $456 | $642 |