| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $67 | $106 | $178 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $211 | $216 | $221 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $60 | $75 | $89 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $69 | $139 | $245 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $44 | $62 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $88 | $156 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $71 | $113 | $169 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $75 | $137 | $206 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $83 | $140 | $222 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $90 | $116 | $131 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $231 | $231 | $231 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $128 | $160 | $192 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $278 | $392 | $490 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $90 | $90 | $90 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $45 | $74 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $60 | $88 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $11 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $103 | $174 | $211 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $81 | $137 | $228 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $63 | $90 | $114 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $56 | $56 | $56 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $147 | $147 | $147 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $21 | $21 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $6 | $6 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $10 | $10 | $10 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $42 | $60 | $79 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $76 | $76 | $76 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $17 | $17 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $10 | $10 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $105 | $105 | $105 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $932 | $932 | $932 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $29 | $29 | $29 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,185 | $2,185 | $2,185 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $194 | $194 | $194 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $774 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $412 | $506 | $649 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $172 | $258 | $301 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $348 | $366 | $384 |
| Septoplasty CPT 30520 • ENT | $552 | $671 | $791 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $107 | $120 | $133 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $102 | $237 | $416 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $362 | $380 | $418 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $344 | $358 | $373 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $368 | $458 | $548 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $195 | $205 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $238 | $402 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $692 | $692 | $692 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $106 | $158 | $189 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $231 | $293 | $324 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $208 | $352 |