| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $5 | $58 | $112 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $60 | $66 | $72 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $28 | $39 | $49 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $41 | $45 | $48 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $41 | $70 | $99 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $38 | $62 | $109 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $17 | $83 | $120 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $20 | $69 | $146 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $15 | $61 | $107 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $12 | $54 | $96 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $74 | $96 | $118 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $101 | $121 | $141 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $74 | $115 | $155 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $183 | $189 | $195 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $41 | $66 | $91 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $38 | $51 | $63 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $17 | $41 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $113 | $120 | $126 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $72 | $89 | $106 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $93 | $109 | $126 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $15 | $41 | $67 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $65 | $115 | $165 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $10 | $14 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $4 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $25 | $33 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $37 | $59 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $51 | $214 | $512 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $101 | $143 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $6 | $7 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $89 | $364 | $897 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $953 | $4,539 | $6,332 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $30 | $165 | $232 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $222 | $893 | $2,235 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $125 | $160 | $194 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $119 | $467 | $815 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $41 | $246 | $452 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $41 | $108 | $176 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $83 | $252 | $421 |
| Septoplasty CPT 30520 • ENT | $115 | $365 | $614 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $33 | $123 | $214 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $185 | $189 | $192 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $62 | $119 | $175 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $41 | $141 | $241 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $184 | $286 | $388 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $41 | $138 | $192 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $291 | $297 | $308 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $347 | $433 | $490 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $41 | $91 | $133 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $41 | $162 | $284 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $29 | $121 | $294 |