| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $119 | $184 | $248 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $144 | $222 | $301 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $92 | $93 | $94 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $114 | $158 | $202 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $95 | $131 | $167 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $108 | $124 | $140 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $118 | $241 | $364 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $101 | $268 | $434 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $111 | $160 | $210 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $129 | $261 | $393 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $184 | $373 | $561 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $146 | $291 | $437 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $237 | $479 | $720 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $122 | $245 | $367 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $96 | $151 | $206 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $52 | $72 | $92 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $7 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $144 | $281 | $418 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $105 | $150 | $194 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $125 | $254 | $382 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $67 | $67 | $67 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $149 | $294 | $438 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $19 | $19 | $19 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $7 | $7 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $50 | $50 | $50 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $39 | $42 | $46 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $60 | $60 | $60 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $15 | $15 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $7 | $7 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $78 | $78 | $78 |
| 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 | $262 | $262 | $262 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $200 | $220 | $240 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $682 | $733 | $783 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $434 | $434 | $434 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $181 | $199 | $217 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $426 | $611 | $795 |
| Septoplasty CPT 30520 • ENT | $606 | $1,191 | $1,776 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $220 | $305 | $389 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $202 | $403 | $605 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $251 | $504 | $756 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $270 | $723 | $1,175 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $396 | $673 | $950 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $196 | $362 | $528 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $314 | $547 | $779 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $500 | $805 | $1,109 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $186 | $367 | $548 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $288 | $565 | $842 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $299 | $586 | $873 |