| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $123 | $239 | $355 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $145 | $148 | $152 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $100 | $145 | $237 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $128 | $157 | $185 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $153 | $223 | $294 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $75 | $200 | $325 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $169 | $183 | $196 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $162 | $298 | $434 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $405 | $405 | $405 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $395 | $395 | $395 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $296 | $323 | $350 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $359 | $359 | $359 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $238 | $366 | $477 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $308 | $443 | $579 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $162 | $238 | $314 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $83 | $106 | $129 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $16 | $16 | $16 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $231 | $260 | $290 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $153 | $213 | $315 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $129 | $235 | $374 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $112 | $200 | $288 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $152 | $164 | $176 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $6 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $46 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $31 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $62 | $66 | $69 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $96 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $7 | $8 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $82 | $504 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $731 | $4,401 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $24 | $113 | $202 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,438 | $2,253 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $289 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $825 | $825 | $825 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $457 | $685 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $190 | $285 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $291 | $467 | $674 |
| Septoplasty CPT 30520 • ENT | $960 | $1,256 | $1,552 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $210 | $423 | $635 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $319 | $446 | $572 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $386 | $392 | $397 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $429 | $718 | $1,008 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $628 | $711 | $793 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $264 | $440 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $498 | $640 | $781 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $793 | $954 | $1,115 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $188 | $257 | $325 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $455 | $650 | $844 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $474 | $602 | $730 |