| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $5 | $46 | $87 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $12 | $59 | $105 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $8 | $88 | $176 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $4 | $109 | $214 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $6 | $91 | $186 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $3 | $146 | $230 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $45 | $122 | $221 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $80 | $157 | $270 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $18 | $159 | $300 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $57 | $151 | $246 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $155 | $251 | $348 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $27 | $134 | $263 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $95 | $265 | $436 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $10 | $163 | $256 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $64 | $115 | $195 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $26 | $77 | $109 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $3 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $66 | $183 | $278 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $38 | $117 | $197 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $43 | $137 | $231 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $46 | $118 | $191 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $48 | $158 | $268 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $7 | $9 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $5 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $15 | $84 | $158 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $45 | $55 | $61 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $76 | $78 | $81 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $20 | $79 | $198 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $51 | $83 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $104 | $629 | $1,020 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $851 | $3,420 | $8,508 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $29 | $188 | $305 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,378 | $2,472 | $2,519 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $32 | $195 | $357 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $498 | $1,303 | $2,329 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $318 | $452 | $587 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $35 | $162 | $290 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $46 | $181 | $317 |
| Septoplasty CPT 30520 • ENT | $105 | $624 | $1,144 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $230 | $362 | $472 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $63 | $88 | $113 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $16 | $149 | $282 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $48 | $396 | $744 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $48 | $313 | $578 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $27 | $175 | $321 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $131 | $419 | $653 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $280 | $664 | $1,038 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $93 | $276 | $395 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $213 | $363 | $512 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $282 | $535 |