| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $24 | $78 | $132 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $100 | $132 | $164 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $66 | $94 | $108 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $27 | $77 | $128 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $21 | $21 | $21 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $45 | $61 | $76 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $83 | $83 | $83 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $101 | $101 | $101 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $76 | $76 | $76 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $92 | $101 | $109 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $69 | $138 | $207 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $151 | $151 | $151 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $163 | $224 | $255 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $70 | $70 | $70 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $31 | $31 | $31 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $30 | $30 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $4 | $4 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $103 | $103 | $103 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $71 | $95 | $120 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $83 | $120 | $140 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $72 | $97 | $122 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $106 | $131 | $156 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $55 | $58 | $63 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $22 | $39 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $295 | $403 | $512 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $78 | $143 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $33 | $36 | $40 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $511 | $703 | $896 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $544 | $3,555 | $6,565 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $136 | $184 | $232 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $205 | $1,519 | $2,736 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $175 | $212 | $250 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $599 | $599 | $599 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $33 | $274 | $463 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $15 | $114 | $175 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $32 | $195 | $366 |
| Septoplasty CPT 30520 • ENT | $428 | $632 | $836 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $89 | $89 | $89 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $127 | $182 | $237 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $87 | $202 | $316 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $162 | $352 | $542 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $216 | $298 | $380 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $120 | $182 | $212 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $177 | $177 | $177 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $200 | $321 | $443 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $81 | $158 | $236 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $165 | $254 | $344 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $200 | $281 | $361 |