| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $43 | $93 | $143 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $135 | $156 | $177 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $53 | $95 | $116 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $89 | $139 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $44 | $49 | $54 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $33 | $33 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $89 | $89 | $89 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $75 | $127 | $179 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $83 | $83 | $83 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $75 | $98 | $121 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $84 | $84 | $84 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $168 | $170 | $172 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $185 | $233 | $282 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $90 | $90 | $90 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $76 | $76 | $76 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $41 | $41 | $41 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $6 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $134 | $134 | $134 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $86 | $86 | $86 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $14 | $58 | $101 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $50 | $90 | $130 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $122 | $150 | $177 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $16 | $25 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $17 | $47 | $70 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $60 | $65 | $71 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $73 | $78 | $83 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $19 | $106 | $194 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $37 | $63 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $114 | $434 | $753 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,010 | $4,736 | $8,462 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $30 | $33 | $36 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $237 | $1,990 | $3,277 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $260 | $310 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $643 | $643 | $643 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $389 | $432 | $474 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $180 | $204 | $216 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $334 | $354 | $374 |
| Septoplasty CPT 30520 • ENT | $461 | $461 | $461 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $174 | $174 | $174 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $60 | $147 | $234 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $256 | $289 | $322 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $218 | $385 | $551 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $322 | $368 | $414 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $158 | $206 | $231 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $254 | $254 | $254 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $406 | $406 | $406 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $48 | $77 | $105 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $226 | $299 | $372 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $236 | $236 | $236 |