| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $48 | $87 | $123 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $152 | $293 | $435 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $26 | $47 | $69 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $81 | $95 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $61 | $82 | $104 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $44 | $150 | $326 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $101 | $113 | $124 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $85 | $122 | $152 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $30 | $284 | $481 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $85 | $112 | $139 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $154 | $154 | $154 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $143 | $167 | $190 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $156 | $209 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $165 | $165 | $165 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $78 | $165 | $322 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $47 | $49 | $52 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $14 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $117 | $144 | $163 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $31 | $120 | $223 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $104 | $114 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $112 | $230 | $347 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $141 | $146 | $152 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $19 | $29 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $46 | $60 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $15 | $47 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $95 | $307 | $518 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $57 | $134 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $13 | $42 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $79 | $379 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,099 | $3,576 | $6,054 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $42 | $156 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $304 | $1,518 | $2,731 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $369 | $385 | $401 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,015 | $1,031 | $1,047 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $449 | $624 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $285 | $327 | $362 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $440 | $653 | $866 |
| Septoplasty CPT 30520 • ENT | $648 | $1,314 | $1,980 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $637 | $637 | $637 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $169 | $182 | $193 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $163 | $391 | $760 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $247 | $339 | $431 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $317 | $630 | $943 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $350 | $525 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $255 | $514 | $773 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $245 | $460 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $193 | $384 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $256 | $415 | $574 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $894 | $894 | $894 |