| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $62 | $125 | $202 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $137 | $205 | $244 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $79 | $157 | $226 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $203 | $236 | $256 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $64 | $148 | $213 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $76 | $125 | $193 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $44 | $143 | $209 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $65 | $217 | $321 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $175 | $213 | $251 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $227 | $255 | $311 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $168 | $217 | $265 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $44 | $268 | $493 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $152 | $444 | $576 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $433 | $433 | $433 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $133 | $166 | $217 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $44 | $94 | $163 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $21 | $55 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $64 | $232 | $323 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $135 | $196 | $236 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $187 | $254 | $304 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $113 | $119 | $126 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $152 | $217 | $283 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $18 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $5 | $11 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $71 | $83 | $93 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $78 | $91 | $105 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $139 | $310 | $481 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $31 | $101 | $170 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $18 | $45 | $71 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $187 | $420 | $653 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,695 | $4,514 | $7,332 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $25 | $39 | $53 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $287 | $1,282 | $2,962 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $228 | $287 | $345 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $559 | $956 | $1,353 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $591 | $675 | $749 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $204 | $241 | $312 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $112 | $682 | $972 |
| Septoplasty CPT 30520 • ENT | $780 | $1,152 | $1,388 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $194 | $347 | $500 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $244 | $370 | $457 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $455 | $507 | $571 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $575 | $596 | $617 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $407 | $712 | $905 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $447 | $461 | $467 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $250 | $505 | $718 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $871 | $1,070 | $1,194 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $168 | $329 | $444 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $361 | $532 | $659 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $64 | $423 | $684 |