| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $12 | $106 | $201 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $30 | $80 | $131 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $10 | $71 | $160 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $5 | $25 | $46 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $101 | $163 | $221 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $55 | $75 | $94 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $44 | $84 | $131 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $94 | $123 | $166 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $102 | $154 | $247 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $96 | $131 | $165 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $37 | $116 | $195 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $32 | $83 | $134 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $22 | $208 | $395 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $79 | $140 | $202 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $20 | $80 | $177 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $44 | $88 | $117 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $18 | $44 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $44 | $148 | $252 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $60 | $62 | $63 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $44 | $127 | $209 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $62 | $123 | $184 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $81 | $170 | $259 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $12 | $24 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $37 | $44 | $48 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $38 | $48 | $67 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $78 | $347 | $481 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $89 | $125 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $32 | $53 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $64 | $78 | $106 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $2,138 | $5,353 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $34 | $123 | $192 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $211 | $887 | $2,114 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $43 | $150 | $257 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $50 | $340 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $159 | $290 | $421 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $26 | $117 | $208 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $135 | $269 | $404 |
| Septoplasty CPT 30520 • ENT | $538 | $553 | $569 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $51 | $131 | $211 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $14 | $161 | $308 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $26 | $163 | $300 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $26 | $350 | $674 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $70 | $218 | $367 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $44 | $126 | $291 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $285 | $288 | $291 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $406 | $600 | $785 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $43 | $253 | $409 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $47 | $256 | $464 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $246 | $263 | $279 |