| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $16 | $127 | $239 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $66 | $177 | $289 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $5 | $36 | $68 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $39 | $71 | $102 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $27 | $114 | $200 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $17 | $118 | $220 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $125 | $182 | $239 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $153 | $222 | $292 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $30 | $177 | $324 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $70 | $168 | $266 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $138 | $257 | $376 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $85 | $186 | $287 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $85 | $199 | $314 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $103 | $173 | $243 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $108 | $156 | $204 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $9 | $67 | $124 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $3 | $4 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $20 | $161 | $301 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $110 | $119 | $128 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $65 | $112 | $158 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $75 | $100 | $125 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $10 | $43 | $75 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $13 | $22 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $52 | $63 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $30 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $57 | $64 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $13 | $15 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $35 | $64 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $365 | $667 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $679 | $786 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $114 | $209 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,438 | $1,640 | $1,843 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $289 | $369 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $448 | $635 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $31 | $243 | $456 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $19 | $104 | $190 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $178 | $360 | $543 |
| Septoplasty CPT 30520 • ENT | $344 | $792 | $1,240 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $16 | $214 | $412 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $79 | $102 | $124 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $115 | $300 | $484 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $116 | $461 | $805 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $42 | $337 | $633 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $34 | $193 | $351 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $33 | $275 | $518 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $105 | $422 | $739 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $13 | $189 | $365 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $134 | $347 | $559 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $210 | $397 | $583 |