| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $4 | $54 | $104 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $13 | $13 | $13 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $40 | $44 | $52 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $36 | $68 | $100 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $3 | $21 | $40 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $65 | $65 | $65 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $45 | $45 | $45 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $40 | $53 | $66 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $67 | $70 | $73 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $96 | $140 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $46 | $46 | $46 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $40 | $79 | $118 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $122 | $140 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $97 | $122 | $147 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $4 | $62 | $96 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $39 | $49 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $13 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $54 | $54 | $54 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $81 | $110 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $40 | $67 | $95 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $10 | $10 | $10 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $99 | $115 | $131 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $23 | $23 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $5 | $6 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $29 | $33 | $38 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $39 | $45 | $51 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $64 | $270 | $476 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $100 | $144 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $8 | $42 | $85 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $60 | $597 | $866 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $777 | $4,272 | $7,767 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $243 | $243 | $244 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,366 | $1,593 | $1,820 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $111 | $111 | $111 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $90 | $650 | $955 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $480 | $480 | $480 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $30 | $30 | $30 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $50 | $50 | $50 |
| Septoplasty CPT 30520 • ENT | $40 | $40 | $40 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $15 | $15 | $15 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $14 | $90 | $165 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $76 | $203 | $329 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $115 | $115 | $115 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $169 | $169 | $169 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $40 | $103 | $166 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $40 | $40 | $40 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $40 | $52 | $64 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $55 | $55 | $55 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $119 | $119 | $119 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $173 | $173 | $173 |