| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $86 | $146 | $244 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $131 | $186 | $295 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $195 | $200 | $202 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $72 | $182 | $241 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $6 | $172 | $308 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $65 | $173 | $230 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $232 | $242 | $251 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $17 | $201 | $294 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $326 | $331 | $336 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $34 | $152 | $270 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $137 | $301 | $387 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $34 | $374 | $650 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $34 | $231 | $473 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $15 | $165 | $390 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $99 | $213 | $328 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $104 | $140 | $190 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $12 | $19 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $14 | $99 | $184 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $53 | $89 | $128 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $13 | $122 | $253 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $38 | $108 | $213 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $52 | $175 | $289 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $16 | $22 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $28 | $32 | $38 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $23 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $48 | $252 | $643 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $57 | $145 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $33 | $85 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $465 | $667 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $555 | $3,067 | $7,860 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $169 | $278 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $1,144 | $1,842 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $23 | $135 | $228 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $90 | $360 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $31 | $243 | $456 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $19 | $109 | $184 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $53 | $245 | $355 |
| Septoplasty CPT 30520 • ENT | $74 | $595 | $1,220 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $422 | $430 | $439 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $118 | $216 | $373 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $27 | $259 | $479 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $232 | $303 | $445 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $209 | $406 | $593 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $85 | $249 | $332 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $50 | $417 | $716 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $79 | $597 | $1,020 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $257 | $339 | $421 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $268 | $478 | $616 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $33 | $272 | $644 |