| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $107 | $148 | $188 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $130 | $152 | $174 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $6 | $54 | $150 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $102 | $142 | $182 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $42 | $100 | $157 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $42 | $56 | $69 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $110 | $116 | $122 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $108 | $122 | $135 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $117 | $133 | $149 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $42 | $103 | $163 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $164 | $196 | $228 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $42 | $151 | $261 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $42 | $177 | $275 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $42 | $137 | $233 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $42 | $103 | $164 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $42 | $48 | $54 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $9 | $25 | $42 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $42 | $114 | $186 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $94 | $111 | $128 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $112 | $141 | $196 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $64 | $99 | $134 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $136 | $157 | $179 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $4 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $12 | $47 | $66 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $10 | $36 | $62 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $489 | $496 | $503 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $107 | $146 | $184 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $41 | $48 | $55 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $106 | $393 | $680 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $312 | $4,682 | $9,052 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $31 | $168 | $304 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $117 | $1,503 | $2,197 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $198 | $239 | $280 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $663 | $663 | $663 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $256 | $341 | $384 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $160 | $188 | $226 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $226 | $326 | $466 |
| Septoplasty CPT 30520 • ENT | $657 | $681 | $705 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $115 | $115 | $115 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $62 | $142 | $222 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $202 | $237 | $273 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $288 | $395 | $502 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $311 | $367 | $423 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $172 | $172 | $174 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $42 | $148 | $255 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $42 | $202 | $362 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $25 | $97 | $158 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $230 | $283 | $337 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $282 | $297 | $311 |