| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $24 | $74 | $119 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $44 | $142 | $239 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $20 | $65 | $112 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $33 | $89 | $152 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $23 | $68 | $112 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $39 | $50 | $72 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $76 | $126 | $193 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $13 | $124 | $236 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $15 | $99 | $183 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $24 | $118 | $212 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $34 | $167 | $300 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $143 | $254 | $365 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $22 | $171 | $268 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $11 | $120 | $318 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $45 | $94 | $151 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $50 | $66 | $92 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $15 | $32 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $91 | $166 | $221 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $71 | $95 | $113 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $78 | $137 | $213 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $73 | $77 | $86 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $34 | $143 | $216 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $21 | $25 | $27 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $7 | $8 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $29 | $46 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $9 | $27 | $60 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $76 | $499 | $711 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $113 | $161 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $30 | $71 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $104 | $682 | $971 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $931 | $6,104 | $8,690 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $29 | $164 | $232 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $306 | $1,848 | $3,055 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $190 | $272 | $313 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $404 | $589 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $411 | $614 | $928 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $171 | $196 | $208 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $60 | $392 | $717 |
| Septoplasty CPT 30520 • ENT | $33 | $536 | $1,017 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $145 | $267 | $371 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $14 | $106 | $175 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $165 | $333 | $538 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $187 | $299 | $462 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $33 | $358 | $678 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $33 | $183 | $334 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $145 | $341 | $537 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $33 | $449 | $855 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $101 | $223 | $314 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $310 | $370 | $489 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $32 | $271 | $509 |