| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $130 | $150 | $170 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $162 | $184 | $206 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $48 | $86 | $106 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $126 | $145 | $165 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $55 | $55 | $55 |
| 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 | $112 | $112 | $112 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $107 | $157 | $208 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $117 | $137 | $157 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $141 | $141 | $141 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $268 | $268 | $268 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $150 | $231 | $312 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $251 | $294 | $336 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $173 | $191 | $209 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $151 | $151 | $151 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $89 | $89 | $89 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $8 | $8 | $8 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $215 | $215 | $215 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $92 | $92 | $92 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $136 | $157 | $178 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $137 | $146 | $154 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $92 | $139 | $185 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $4 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $10 | $64 | $104 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $6 | $40 | $74 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $51 | $371 | $692 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $126 | $239 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $6 | $8 | $10 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $65 | $656 | $1,248 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $592 | $5,675 | $10,758 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $20 | $188 | $356 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $223 | $2,759 | $4,027 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $217 | $252 | $288 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $850 | $850 | $850 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $58 | $368 | $575 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $196 | $220 | $233 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $248 | $443 | $725 |
| Septoplasty CPT 30520 • ENT | $884 | $1,271 | $1,658 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $294 | $294 | $294 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $261 | $359 | $458 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $346 | $484 | $623 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $339 | $707 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $452 | $621 | $790 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $213 | $226 | $251 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $369 | $508 | $646 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $448 | $488 | $527 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $252 | $257 | $261 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $399 | $554 | $709 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $416 | $578 | $740 |