| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $35 | $77 | $119 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $144 | $144 | $144 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $41 | $67 | $92 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $53 | $76 | $100 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $95 | $95 | $95 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $111 | $111 | $111 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $64 | $91 | $118 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $66 | $107 | $147 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $118 | $164 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $134 | $134 | $134 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $116 | $116 | $116 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $146 | $146 | $146 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $237 | $237 | $237 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $124 | $124 | $124 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $38 | $41 | $43 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $50 | $53 | $57 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $5 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $148 | $148 | $148 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $68 | $83 | $94 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $100 | $105 | $112 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $67 | $67 | $67 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $149 | $149 | $149 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $54 | $54 | $54 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $51 | $51 | $51 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $61 | $61 | $61 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $14 | $15 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $7 | $7 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $60 | $70 | $81 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $704 | $704 | $704 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $23 | $23 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,787 | $1,787 | $1,787 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $215 | $245 | $275 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $498 | $665 | $833 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $434 | $434 | $434 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $177 | $178 | $181 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $426 | $426 | $426 |
| Septoplasty CPT 30520 • ENT | $618 | $618 | $618 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $108 | $108 | $108 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $133 | $143 | $154 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $196 | $263 | $329 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $403 | $403 | $403 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $252 | $252 | $252 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $178 | $178 | $178 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $207 | $207 | $207 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $295 | $295 | $295 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $134 | $163 | $192 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $288 | $288 | $288 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $233 | $233 | $233 |