| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $21 | $29 | $38 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $10 | $63 | $117 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $10 | $27 | $44 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $9 | $51 | $93 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $33 | $57 | $81 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $11 | $47 | $89 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $18 | $53 | $97 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $66 | $93 | $118 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $104 | $131 | $159 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $19 | $63 | $107 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $82 | $88 | $94 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $42 | $96 | $132 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $29 | $77 | $125 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $133 | $159 | $189 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $10 | $32 | $44 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $31 | $44 | $61 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $16 | $44 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $44 | $76 | $110 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $45 | $48 | $52 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $15 | $58 | $101 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $25 | $57 | $89 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $24 | $38 | $51 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $6 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $8 | $27 | $37 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $22 | $38 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $149 | $360 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $86 | $125 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $32 | $53 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $51 | $338 | $481 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $437 | $3,269 | $5,353 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $117 | $192 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $173 | $1,291 | $2,114 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $43 | $108 | $174 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $100 | $374 | $525 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $285 | $301 | $318 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $35 | $88 | $141 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $96 | $157 | $219 |
| Septoplasty CPT 30520 • ENT | $499 | $538 | $577 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $167 | $212 | $257 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $148 | $184 | $219 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $123 | $170 | $217 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $44 | $184 | $325 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $35 | $143 | $252 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $29 | $71 | $140 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $206 | $246 | $285 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $81 | $188 | $294 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $147 | $152 | $162 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $157 | $190 | $224 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $230 | $232 | $233 |