| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $104 | $162 | $278 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $130 | $233 | $337 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $84 | $98 | $127 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $102 | $131 | $161 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $37 | $78 | $118 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $153 | $153 | $153 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $211 | $211 | $211 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $56 | $157 | $258 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $71 | $208 | $346 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $118 | $198 | $278 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $167 | $242 | $317 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $365 | $365 | $365 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $227 | $390 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $330 | $330 | $330 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $96 | $130 | $164 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $57 | $97 | $138 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $13 | $32 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $439 | $439 | $439 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $81 | $106 | $144 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $79 | $113 | $167 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $108 | $109 | $110 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $99 | $191 | $328 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $13 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $48 | $57 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $31 | $50 | $69 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $67 | $86 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $19 | $99 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $40 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $116 | $521 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,052 | $2,663 | $4,274 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $27 | $30 | $33 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,788 | $2,465 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $181 | $236 | $291 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $839 | $897 | $955 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $392 | $419 | $446 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $165 | $191 | $203 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $286 | $411 | $660 |
| Septoplasty CPT 30520 • ENT | $657 | $809 | $961 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $30 | $164 | $298 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $178 | $216 | $254 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $248 | $380 | $512 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $421 | $521 | $621 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $318 | $623 | $927 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $177 | $266 | $442 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $259 | $494 | $729 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $1,177 | $1,177 | $1,177 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $186 | $258 | $401 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $289 | $472 | $655 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $710 | $710 | $710 |