| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $129 | $158 | $187 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $138 | $150 | $156 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $72 | $78 | $91 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $96 | $101 | $110 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $45 | $71 | $96 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $45 | $79 | $104 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $114 | $119 | $124 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $45 | $124 | $178 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $112 | $155 | $198 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $77 | $123 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $225 | $225 | $225 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $136 | $136 | $136 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $148 | $217 | $252 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $236 | $236 | $236 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $50 | $83 | $100 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $45 | $63 | $84 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $7 | $21 | $45 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $45 | $122 | $177 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $101 | $110 | $116 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $137 | $142 | $153 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $105 | $105 | $105 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $60 | $60 | $60 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $30 | $30 | $30 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $10 | $10 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $67 | $67 | $67 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $69 | $89 | $109 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $126 | $126 | $126 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $12 | $12 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $5 | $5 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $179 | $179 | $179 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $525 | $525 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $42 | $42 | $42 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $3,554 | $3,554 | $3,554 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $208 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $630 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $453 | $498 | $588 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $223 | $231 | $245 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $124 | $392 | $538 |
| Septoplasty CPT 30520 • ENT | $590 | $609 | $624 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $166 | $203 | $240 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $26 | $133 | $202 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $231 | $320 | $378 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $270 | $327 | $384 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $45 | $300 | $555 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $165 | $186 | $196 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $45 | $191 | $314 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $365 | $700 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $188 | $212 | $235 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $264 | $288 | $307 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $276 | $300 | $320 |