| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $88 | $111 | $147 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $47 | $137 | $182 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $28 | $83 | $118 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $84 | $121 | $184 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $83 | $117 | $152 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $75 | $82 | $91 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $99 | $124 | $148 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $121 | $148 | $181 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $88 | $119 | $177 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $82 | $151 | $205 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $156 | $227 | $294 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $118 | $175 | $233 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $188 | $283 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $100 | $203 | $306 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $87 | $109 | $161 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $51 | $72 | $102 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $14 | $36 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $78 | $117 | $155 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $88 | $120 | $169 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $65 | $120 | $201 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $91 | $91 | $91 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $128 | $128 | $128 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $4 | $4 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $29 | $29 | $29 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $22 | $47 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $39 | $39 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $12 | $14 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $21 | $38 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $51 | $65 | $79 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $437 | $437 | $437 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $14 | $14 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,154 | $1,154 | $1,154 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $174 | $174 | $174 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $525 | $525 | $525 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $285 | $285 | $285 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $141 | $213 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $142 | $406 | $670 |
| Septoplasty CPT 30520 • ENT | $512 | $733 | $954 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $172 | $190 | $208 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $51 | $184 | $317 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $200 | $298 | $395 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $194 | $310 | $426 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $259 | $442 | $624 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $144 | $226 | $308 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $211 | $353 | $495 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $302 | $545 | $788 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $152 | $182 | $212 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $230 | $341 | $452 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $240 | $355 | $471 |