| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $118 | $179 | $239 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $144 | $217 | $289 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $94 | $97 | $104 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $113 | $124 | $135 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $102 | $104 | $107 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $45 | $86 | $127 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $197 | $197 | $197 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $228 | $268 | $309 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $165 | $212 | $260 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $137 | $182 | $226 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $184 | $229 | $273 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $222 | $267 | $311 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $201 | $253 | $330 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $117 | $197 | $277 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $96 | $125 | $153 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $108 | $108 | $108 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $9 | $14 | $18 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $348 | $353 | $358 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $102 | $130 | $157 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $121 | $140 | $178 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $71 | $93 | $115 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $162 | $207 | $252 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $22 | $36 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $5 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $43 | $55 | $66 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $36 | $74 | $111 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $140 | $276 | $411 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $32 | $77 | $121 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $10 | $16 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $200 | $481 | $761 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,716 | $3,590 | $5,463 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $47 | $129 | $211 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $241 | $823 | $1,833 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $280 | $281 | $281 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $798 | $1,044 | $1,291 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $390 | $526 | $610 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $162 | $223 | $254 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $223 | $402 | $673 |
| Septoplasty CPT 30520 • ENT | $706 | $783 | $860 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $157 | $260 | $362 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $202 | $256 | $311 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $268 | $419 | $570 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $459 | $493 | $527 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $346 | $564 | $781 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $193 | $255 | $381 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $324 | $470 | $616 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $445 | $715 | $985 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $153 | $225 | $297 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $299 | $400 | $500 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $312 | $427 | $542 |