| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $11 | $99 | $210 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $10 | $164 | $260 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $72 | $145 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $15 | $133 | $203 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $42 | $48 | $61 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $42 | $108 | $170 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $85 | $184 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $18 | $94 | $222 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $30 | $81 | $172 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $42 | $100 | $200 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $10 | $208 | $328 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $20 | $96 | $227 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $268 | $404 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $76 | $182 | $298 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $76 | $157 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $29 | $57 | $99 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $18 | $42 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $42 | $119 | $164 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $66 | $139 | $186 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $126 | $219 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $32 | $67 | $104 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $136 | $168 | $232 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $48 | $54 | $63 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $30 | $46 | $62 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $390 | $565 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $23 | $130 | $184 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $64 | $107 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $46 | $518 | $754 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $422 | $6,175 | $9,052 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $15 | $116 | $304 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $177 | $2,171 | $3,169 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $30 | $143 | $201 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $550 | $669 | $788 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $199 | $318 | $437 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $16 | $119 | $182 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $326 | $492 | $653 |
| Septoplasty CPT 30520 • ENT | $99 | $720 | $1,132 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $42 | $143 | $338 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $33 | $218 | $313 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $273 | $361 | $425 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $58 | $402 | $734 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $317 | $488 | $609 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $105 | $205 | $301 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $336 | $429 | $483 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $53 | $452 | $768 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $158 | $239 | $339 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $34 | $329 | $484 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $53 | $359 | $535 |