| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $49 | $141 | $213 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $99 | $124 | $149 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $181 | $254 | $327 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $33 | $103 | $213 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $56 | $124 | $257 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $68 | $146 | $223 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $81 | $89 | $97 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $78 | $156 | $269 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $145 | $237 | $329 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $118 | $267 | $362 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $106 | $164 | $223 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $103 | $260 | $416 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $137 | $225 | $313 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $304 | $475 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $159 | $254 | $428 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $74 | $176 | $243 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $69 | $112 | $141 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $9 | $12 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $119 | $224 | $356 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $58 | $143 | $239 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $77 | $154 | $279 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $39 | $144 | $248 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $70 | $202 | $334 |
| 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 | $40 | $59 | $79 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $4 | $4 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $38 | $38 | $38 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $10 | $10 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $4 | $4 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $50 | $50 | $50 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $440 | $440 | $440 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $15 | $15 | $15 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $166 | $166 | $166 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $160 | $160 | $160 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $419 | $419 | $419 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $348 | $348 | $348 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $145 | $145 | $145 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $426 | $534 | $629 |
| Septoplasty CPT 30520 • ENT | $553 | $1,099 | $1,438 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $226 | $275 | $323 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $195 | $296 | $398 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $131 | $728 | $1,301 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $344 | $1,098 | $2,021 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $510 | $598 | $685 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $248 | $328 | $381 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $402 | $995 | $2,021 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $644 | $1,155 | $2,021 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $189 | $239 | $288 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $325 | $473 | $620 |