| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $43 | $95 | $135 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $13 | $63 | $130 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $38 | $61 | $83 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $23 | $55 | $102 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $31 | $38 | $42 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $10 | $25 | $42 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $42 | $49 | $64 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $42 | $90 | $165 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $15 | $49 | $89 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $58 | $84 | $109 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $51 | $106 | $164 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $20 | $100 | $180 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $129 | $161 | $212 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $108 | $134 | $160 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $12 | $27 | $42 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $42 | $50 | $57 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $29 | $42 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $17 | $50 | $82 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $66 | $78 | $94 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $42 | $73 | $112 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $13 | $67 | $124 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $9 | $97 | $145 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $31 | $47 | $64 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $47 | $63 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $62 | $297 | $753 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $125 | $184 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $42 | $108 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $41 | $684 | $1,005 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $370 | $3,442 | $9,052 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $25 | $120 | $304 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $139 | $1,208 | $3,168 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $20 | $123 | $198 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $110 | $265 | $420 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $40 | $134 | $228 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $16 | $120 | $184 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $194 | $375 | $466 |
| Septoplasty CPT 30520 • ENT | $568 | $627 | $658 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $42 | $117 | $192 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $14 | $136 | $222 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $128 | $191 | $273 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $213 | $263 | $289 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $42 | $273 | $423 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $105 | $170 | $209 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $42 | $175 | $252 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $42 | $164 | $342 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $42 | $69 | $120 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $42 | $209 | $337 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $42 | $184 | $266 |