| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $244 | $275 | $307 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $137 | $220 | $302 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $125 | $165 | $246 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $236 | $267 | $298 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $204 | $231 | $258 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $227 | $255 | $284 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $162 | $239 | $316 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $206 | $233 | $260 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $285 | $309 | $334 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $264 | $271 | $277 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $300 | $342 | $385 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $284 | $423 | $562 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $472 | $537 | $601 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $311 | $352 | $394 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $100 | $191 | $282 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $104 | $120 | $135 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $9 | $13 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $190 | $215 | $241 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $220 | $250 | $280 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $162 | $248 | $327 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $119 | $174 | $230 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $63 | $179 | $296 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $3 | $3 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $1 | $1 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $36 | $36 | $36 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $16 | $16 | $16 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $28 | $28 | $28 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $8 | $8 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $2 | $2 | $2 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $36 | $36 | $36 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $283 | $283 | $283 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $97 | $97 | $97 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $124 | $124 | $124 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $163 | $163 | $163 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $154 | $154 | $154 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $268 | $268 | $268 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $132 | $132 | $132 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $297 | $479 | $581 |
| Septoplasty CPT 30520 • ENT | $680 | $1,130 | $1,580 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $219 | $325 | $431 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $64 | $217 | $371 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $258 | $379 | $501 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $437 | $647 | $857 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $321 | $472 | $624 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $179 | $227 | $251 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $264 | $388 | $512 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $375 | $552 | $729 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $194 | $242 | $266 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $295 | $431 | $568 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $308 | $452 | $597 |