| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $53 | $184 | $272 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $236 | $280 | $329 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $165 | $199 | $226 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $203 | $246 | $279 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $42 | $141 | $213 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $42 | $159 | $243 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $175 | $224 | $287 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $65 | $220 | $321 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $71 | $271 | $384 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $39 | $186 | $292 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $416 | $416 | $416 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $64 | $279 | $493 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $102 | $404 | $576 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $42 | $160 | $278 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $40 | $126 | $217 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $51 | $98 | $163 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $27 | $55 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $309 | $316 | $323 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $72 | $166 | $256 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $280 | $296 | $304 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $126 | $126 | $126 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $283 | $283 | $283 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $19 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $11 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $36 | $57 | $86 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $78 | $91 | $105 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $139 | $298 | $458 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $31 | $91 | $150 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $6 | $12 | $18 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $187 | $516 | $846 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,695 | $4,442 | $7,188 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $53 | $155 | $256 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $596 | $1,721 | $2,671 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $345 | $345 | $345 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,353 | $1,353 | $1,353 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $591 | $670 | $749 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $170 | $241 | $312 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $167 | $724 | $1,016 |
| Septoplasty CPT 30520 • ENT | $780 | $1,205 | $1,446 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $329 | $415 | $500 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $81 | $342 | $481 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $365 | $472 | $599 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $617 | $632 | $646 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $407 | $737 | $947 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $447 | $461 | $467 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $167 | $477 | $718 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $871 | $1,007 | $1,143 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $168 | $307 | $444 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $361 | $551 | $685 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $521 | $603 | $684 |