| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $60 | $139 | $175 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $86 | $165 | $205 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $40 | $72 | $132 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $115 | $137 | $161 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $40 | $47 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $72 | $156 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $18 | $122 | $169 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $10 | $125 | $206 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $112 | $165 | $225 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $97 | $164 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $138 | $144 | $150 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $198 | $234 | $282 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $44 | $224 | $310 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $44 | $128 | $245 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $20 | $97 | $172 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $69 | $80 | $90 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $5 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $61 | $135 | $209 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $55 | $110 | $151 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $51 | $148 | $200 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $85 | $105 | $124 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $47 | $69 | $91 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $11 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $47 | $48 | $49 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $28 | $36 | $42 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $48 | $161 | $360 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $89 | $125 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $38 | $53 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $104 | $409 | $641 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $535 | $2,273 | $5,353 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $29 | $138 | $192 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $211 | $214 | $218 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $190 | $203 | $215 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $249 | $507 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $64 | $264 | $412 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $172 | $174 | $177 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $38 | $327 | $551 |
| Septoplasty CPT 30520 • ENT | $791 | $863 | $900 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $124 | $313 | $536 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $86 | $198 | $247 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $341 | $385 | $439 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $52 | $500 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $428 | $468 | $548 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $39 | $182 | $269 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $43 | $247 | $434 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $304 | $435 | $692 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $22 | $98 | $241 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $220 | $352 | $407 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $222 | $425 |