| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $43 | $111 | $183 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $65 | $139 | $220 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $15 | $95 | $145 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $10 | $62 | $102 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $5 | $81 | $152 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $4 | $37 | $67 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $63 | $123 | $183 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $26 | $129 | $210 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $14 | $131 | $247 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $115 | $132 | $149 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $124 | $191 | $287 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $19 | $117 | $214 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $149 | $239 | $357 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $81 | $132 | $182 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $20 | $89 | $159 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $32 | $63 | $94 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $9 | $31 | $42 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $26 | $106 | $153 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $66 | $86 | $97 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $42 | $115 | $190 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $32 | $84 | $155 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $27 | $125 | $212 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $33 | $64 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $10 | $33 | $62 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $32 | $456 | $693 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $110 | $184 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $38 | $100 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $41 | $351 | $890 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $370 | $5,830 | $9,052 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $12 | $92 | $228 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $139 | $1,630 | $2,376 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $20 | $123 | $198 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $275 | $415 | $549 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $304 | $450 | $596 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $123 | $136 | $160 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $42 | $292 | $466 |
| Septoplasty CPT 30520 • ENT | $99 | $531 | $838 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $36 | $112 | $187 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $103 | $192 | $251 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $85 | $229 | $328 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $42 | $292 | $546 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $419 | $492 | $635 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $42 | $163 | $233 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $63 | $240 | $342 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $79 | $338 | $488 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $158 | $209 | $261 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $337 | $411 | $507 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $70 | $239 | $407 |