| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $57 | $96 | $134 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $69 | $118 | $167 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $29 | $82 | $109 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $81 | $106 | $131 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $41 | $52 | $63 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $42 | $42 | $42 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $111 | $111 | $111 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $132 | $132 | $132 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $101 | $143 | $185 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $92 | $92 | $92 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $167 | $190 | $212 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $194 | $194 | $194 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $209 | $246 | $264 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $173 | $173 | $173 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $61 | $61 | $61 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $67 | $67 | $67 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $4 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $133 | $133 | $133 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $56 | $88 | $121 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $109 | $131 | $142 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $40 | $78 | $116 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $56 | $106 | $157 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $17 | $28 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $9 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $44 | $54 | $60 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $14 | $27 | $41 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $105 | $325 | $545 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $24 | $82 | $141 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $6 | $9 | $12 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $149 | $440 | $732 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,287 | $3,830 | $6,373 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $38 | $103 | $167 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $302 | $1,702 | $2,402 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $214 | $220 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $544 | $756 | $968 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $452 | $460 | $477 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $188 | $192 | $199 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $355 | $366 | $387 |
| Septoplasty CPT 30520 • ENT | $543 | $679 | $814 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $205 | $205 | $205 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $77 | $151 | $224 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $307 | $312 | $318 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $289 | $407 | $525 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $390 | $409 | $429 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $209 | $215 | $217 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $319 | $329 | $338 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $540 | $540 | $540 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $34 | $83 | $131 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $290 | $318 | $346 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $304 | $304 | $304 |