| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $136 | $207 | $269 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $326 | $354 | $400 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $67 | $126 | $251 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $163 | $264 | $318 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $108 | $191 | $275 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $115 | $188 | $295 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $169 | $277 | $340 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $202 | $288 | $384 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $114 | $334 | $454 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $286 | $321 | $355 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $322 | $421 | $520 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $400 | $501 | $602 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $222 | $449 | $650 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $337 | $437 | $537 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $140 | $221 | $302 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $72 | $150 | $198 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $9 | $15 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $209 | $306 | $441 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $150 | $207 | $303 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $87 | $197 | $354 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $165 | $230 | $295 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $166 | $258 | $349 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $50 | $50 | $50 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $7 | $12 | $17 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $57 | $104 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $160 | $160 | $160 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $212 | $212 | $212 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $27 | $27 | $27 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $5 | $5 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $61 | $61 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $2,589 | $2,589 | $2,589 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $81 | $81 | $81 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $2,118 | $4,027 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $296 | $296 | $296 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $630 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $576 | $610 | $643 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $184 | $209 | $233 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $357 | $528 | $775 |
| Septoplasty CPT 30520 • ENT | $1,759 | $1,891 | $2,024 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $398 | $471 | $544 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $506 | $586 | $666 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $694 | $764 | $833 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $900 | $1,023 | $1,146 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $811 | $1,066 | $1,320 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $213 | $294 | $457 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $666 | $856 | $1,047 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $948 | $1,307 | $1,667 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $20 | $411 | $706 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $730 | $745 | $760 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $793 | $962 | $1,131 |