| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $51 | $223 | $418 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $61 | $125 | $189 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $11 | $174 | $337 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $6 | $206 | $407 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $6 | $179 | $353 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $4 | $196 | $389 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $46 | $163 | $280 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $33 | $268 | $521 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $128 | $217 | $386 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $11 | $244 | $478 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $74 | $367 | $659 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $17 | $390 | $762 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $12 | $275 | $538 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $31 | $354 | $677 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $15 | $200 | $384 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $4 | $113 | $224 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $11 | $22 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $58 | $194 | $331 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $5 | $138 | $223 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $77 | $176 | $274 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $38 | $212 | $386 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $31 | $123 | $214 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $47 | $73 | $96 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $10 | $58 | $117 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $94 | $324 | $554 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $21 | $24 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $42 | $74 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $100 | $113 | $126 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,099 | $5,065 | $9,032 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $37 | $181 | $325 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $318 | $1,539 | $2,761 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $36 | $219 | $401 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $602 | $824 | $1,047 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $59 | $464 | $869 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $32 | $197 | $362 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $178 | $656 | $1,117 |
| Septoplasty CPT 30520 • ENT | $344 | $1,145 | $2,560 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $189 | $506 | $824 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $25 | $362 | $708 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $93 | $499 | $966 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $156 | $905 | $1,653 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $625 | $1,219 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $23 | $351 | $679 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $182 | $591 | $1,000 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $77 | $750 | $1,423 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $21 | $284 | $506 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $203 | $598 | $1,089 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $33 | $586 | $1,140 |