| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $65 | $100 | $135 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $59 | $113 | $167 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $37 | $81 | $125 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $55 | $96 | $153 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $40 | $40 | $40 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $50 | $127 | $204 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $67 | $113 | $159 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $102 | $141 | $168 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $185 | $200 | $216 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $50 | $127 | $246 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $120 | $120 | $120 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $48 | $156 | $265 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $236 | $236 | $236 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $164 | $164 | $164 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $50 | $92 | $140 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $70 | $83 | $96 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $6 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $174 | $175 | $176 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $141 | $168 | $181 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $123 | $123 | $123 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $104 | $104 | $104 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $210 | $210 | $210 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $41 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $39 | $47 | $54 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $58 | $66 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $89 | $165 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $31 | $55 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $81 | $362 | $643 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $551 | $4,189 | $7,826 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $151 | $278 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,787 | $2,368 | $2,948 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $208 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $734 | $734 | $734 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $452 | $684 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $189 | $189 | $189 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $217 | $329 | $480 |
| Septoplasty CPT 30520 • ENT | $666 | $861 | $1,099 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $381 | $381 | $381 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $78 | $165 | $304 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $192 | $339 | $413 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $320 | $320 | $320 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $397 | $397 | $397 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $220 | $220 | $220 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $259 | $387 | $475 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $499 | $499 | $499 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $158 | $167 | $176 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $285 | $377 | $470 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $490 | $506 | $536 |