| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $135 | $241 | $347 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $58 | $112 | $167 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $80 | $86 | $99 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $336 | $336 | $336 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $113 | $113 | $113 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $50 | $80 | $109 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $119 | $128 | $138 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $119 | $271 | $424 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $161 | $173 | $185 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $132 | $132 | $132 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $340 | $340 | $340 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $636 | $636 | $636 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $235 | $235 | $235 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $561 | $561 | $561 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $105 | $111 | $116 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $62 | $62 | $62 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $7 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $214 | $326 | $438 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $64 | $92 | $120 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $124 | $124 | $124 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $313 | $313 | $313 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $154 | $154 | $154 |
| 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 | $3 | $3 | $3 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $33 | $33 | $33 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $12 | $12 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $5 | $5 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $63 | $63 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $382 | $382 | $382 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $20 | $20 | $20 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,438 | $1,438 | $1,438 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $210 | $210 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $823 | $823 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $304 | $304 | $304 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $127 | $127 | $127 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $173 | $173 | $173 |
| Septoplasty CPT 30520 • ENT | $617 | $617 | $617 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $205 | $205 | $205 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $230 | $380 | $531 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $704 | $704 | $704 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $401 | $401 | $401 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $922 | $922 | $922 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $175 | $175 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $258 | $258 | $258 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $1,077 | $1,077 | $1,077 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $129 | $129 | $129 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $814 | $814 | $814 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $291 | $291 | $291 |