| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $90 | $142 | $195 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $303 | $303 | $303 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $71 | $108 | $156 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $130 | $166 | $237 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $36 | $114 | $205 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $54 | $99 | $122 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $113 | $144 | $180 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $213 | $242 | $300 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $132 | $132 | $132 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $210 | $210 | $210 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $435 | $435 | $435 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $239 | $264 | $289 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $314 | $329 | $337 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $253 | $253 | $253 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $99 | $119 | $144 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $77 | $104 | $128 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $6 | $12 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $327 | $327 | $327 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $134 | $144 | $148 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $163 | $172 | $176 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $108 | $168 | $228 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $321 | $321 | $321 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $4 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $11 | $24 | $49 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $3 | $21 | $39 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $406 | $764 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $92 | $109 | $126 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $35 | $59 | $83 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $54 | $536 | $1,019 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $551 | $3,026 | $5,500 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $30 | $70 | $109 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $296 | $1,518 | $2,130 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $211 | $247 | $284 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $968 | $968 | $968 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $317 | $364 | $434 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $191 | $196 | $198 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $627 | $627 | $628 |
| Septoplasty CPT 30520 • ENT | $876 | $1,101 | $1,326 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $318 | $318 | $318 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $125 | $232 | $285 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $502 | $510 | $514 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $468 | $651 | $834 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $666 | $684 | $694 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $279 | $319 | $339 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $262 | $420 | $547 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $370 | $659 | $875 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $167 | $240 | $277 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $467 | $503 | $574 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $491 | $547 | $603 |