| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $62 | $155 | $269 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $326 | $354 | $382 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $67 | $156 | $245 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $163 | $234 | $304 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $251 | $251 | $251 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $156 | $221 | $287 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $155 | $213 | $315 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $206 | $265 | $380 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $175 | $237 | $299 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $198 | $270 | $342 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $313 | $313 | $313 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $585 | $585 | $585 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $167 | $401 | $635 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $512 | $512 | $512 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $134 | $134 | $135 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $72 | $115 | $171 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $9 | $15 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $209 | $236 | $262 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $72 | $189 | $280 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $87 | $206 | $257 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $177 | $177 | $177 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $391 | $391 | $391 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $23 | $23 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $7 | $7 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $39 | $39 | $39 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $52 | $52 | $52 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $65 | $65 | $65 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $16 | $16 | $16 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $8 | $8 | $8 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $84 | $84 | $84 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $763 | $763 | $763 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $25 | $25 | $25 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,895 | $1,895 | $1,895 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $216 | $216 | $216 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $848 | $1,581 | $2,313 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $470 | $470 | $470 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $196 | $196 | $196 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $102 | $377 | $1,137 |
| Septoplasty CPT 30520 • ENT | $102 | $836 | $1,625 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $585 | $585 | $585 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $69 | $236 | $535 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $102 | $358 | $672 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $102 | $416 | $730 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $102 | $527 | $1,071 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $528 | $528 | $528 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $102 | $373 | $850 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $1,353 | $1,353 | $1,353 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $102 | $183 | $361 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $361 | $582 | $777 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $806 | $806 | $806 |