| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $83 | $132 | $169 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $86 | $132 | $177 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $67 | $80 | $86 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $137 | $147 | $163 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $55 | $67 | $80 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $98 | $126 | $156 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $97 | $146 | $172 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $182 | $200 | $214 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $114 | $162 | $237 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $127 | $200 | $273 |
| 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 | $307 | $318 | $329 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $167 | $247 | $361 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $285 | $347 | $408 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $112 | $117 | $123 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $72 | $95 | $118 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $7 | $8 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $205 | $225 | $261 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $103 | $126 | $150 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $14 | $76 | $128 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $100 | $115 | $130 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $104 | $141 | $177 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $13 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $42 | $61 | $70 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $55 | $58 | $60 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $76 | $408 | $739 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $106 | $194 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $47 | $85 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $104 | $554 | $1,004 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $932 | $4,697 | $8,462 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $29 | $30 | $30 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $327 | $1,930 | $3,277 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $190 | $250 | $310 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $774 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $412 | $443 | $474 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $152 | $195 | $216 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $374 | $462 | $551 |
| Septoplasty CPT 30520 • ENT | $791 | $791 | $791 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $170 | $170 | $170 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $234 | $256 | $279 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $322 | $404 | $487 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $373 | $462 | $551 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $414 | $525 | $636 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $231 | $243 | $269 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $504 | $618 | $732 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $804 | $804 | $804 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $48 | $145 | $241 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $372 | $412 | $452 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $390 | $430 | $470 |