| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $50 | $136 | $221 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $6 | $137 | $268 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $26 | $94 | $176 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $126 | $214 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $4 | $92 | $202 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $5 | $146 | $230 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $75 | $107 | $145 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $24 | $199 | $302 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $9 | $180 | $300 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $84 | $133 | $182 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $31 | $189 | $348 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $84 | $174 | $263 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $12 | $224 | $436 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $79 | $231 | $358 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $6 | $102 | $195 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $4 | $69 | $109 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $5 | $11 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $26 | $203 | $305 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $44 | $81 | $118 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $12 | $122 | $231 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $46 | $118 | $191 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $61 | $85 | $109 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $7 | $9 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $78 | $92 | $118 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $44 | $55 | $60 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $81 | $537 | $765 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $20 | $79 | $198 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $58 | $84 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $102 | $160 | $275 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $851 | $3,420 | $8,508 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $29 | $30 | $31 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $856 | $1,918 | $2,519 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $108 | $233 | $357 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $75 | $578 | $1,082 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $32 | $312 | $587 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $26 | $158 | $290 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $124 | $312 | $501 |
| Septoplasty CPT 30520 • ENT | $105 | $624 | $1,144 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $32 | $232 | $383 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $20 | $180 | $340 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $196 | $239 | $282 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $226 | $330 | $433 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $241 | $409 | $578 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $89 | $196 | $321 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $262 | $332 | $472 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $75 | $596 | $1,038 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $132 | $256 | $395 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $28 | $270 | $512 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $148 | $436 | $626 |