| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $17 | $67 | $117 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $11 | $78 | $145 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $3 | $48 | $92 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $11 | $63 | $114 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $7 | $7 | $7 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $42 | $74 | $107 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $90 | $90 | $90 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $15 | $80 | $145 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $81 | $81 | $81 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $76 | $105 | $134 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $17 | $100 | $183 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $107 | $107 | $107 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $115 | $172 | $228 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $18 | $18 | $18 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $21 | $21 | $21 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $8 | $8 | $8 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $5 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $117 | $117 | $117 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $10 | $58 | $106 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $19 | $71 | $123 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $21 | $65 | $108 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $7 | $77 | $147 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $8 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $23 | $56 | $89 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $46 | $55 | $64 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $78 | $444 | $809 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $214 | $223 | $232 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $75 | $83 | $90 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $1,024 | $1,061 | $1,097 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $848 | $5,046 | $9,245 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $295 | $311 | $326 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,717 | $3,167 | $3,617 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $137 | $202 | $268 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $286 | $472 | $657 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $89 | $263 | $436 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $122 | $181 | $240 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $193 | $235 | $276 |
| Septoplasty CPT 30520 • ENT | $440 | $535 | $631 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $41 | $41 | $41 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $6 | $90 | $175 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $112 | $175 | $238 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $41 | $224 | $408 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $225 | $261 | $296 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $126 | $147 | $168 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $25 | $25 | $25 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $70 | $70 | $70 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $18 | $18 | $18 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $203 | $237 | $270 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $28 | $28 | $28 |