| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $88 | $124 | $184 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $122 | $175 | $229 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $69 | $93 | $148 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $74 | $84 | $93 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $28 | $91 | $155 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $66 | $73 | $80 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $61 | $93 | $125 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $79 | $121 | $156 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $164 | $254 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $159 | $159 | $159 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $148 | $220 | $291 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $337 | $337 | $337 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $211 | $361 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $186 | $186 | $186 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $95 | $132 | $169 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $40 | $63 | $100 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $8 | $10 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $118 | $131 | $144 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $81 | $112 | $168 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $124 | $196 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $75 | $113 | $151 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $79 | $118 | $157 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $4 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $36 | $43 | $47 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $21 | $52 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $28 | $291 | $554 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $81 | $167 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $23 | $38 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $36 | $71 | $99 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $283 | $4,657 | $9,031 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $10 | $126 | $243 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $124 | $1,206 | $3,176 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $163 | $203 | $243 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $154 | $154 | $154 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $268 | $329 | $391 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $132 | $185 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $36 | $217 | $355 |
| Septoplasty CPT 30520 • ENT | $491 | $745 | $1,000 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $322 | $322 | $322 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $94 | $133 | $172 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $205 | $220 | $234 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $208 | $425 | $642 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $304 | $388 | $471 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $152 | $189 | $263 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $242 | $315 | $388 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $383 | $467 | $551 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $32 | $172 | $285 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $289 | $361 | $433 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $452 | $452 | $452 |