| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $54 | $76 | $107 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $130 | $141 | $163 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $8 | $67 | $107 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $10 | $82 | $130 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $13 | $56 | $113 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $41 | $72 | $124 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $10 | $62 | $135 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $9 | $86 | $165 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $42 | $99 | $183 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $42 | $65 | $112 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $77 | $124 | $164 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $39 | $81 | $162 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $42 | $156 | $266 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $42 | $144 | $218 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $4 | $65 | $119 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $11 | $43 | $70 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $13 | $42 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $19 | $87 | $170 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $9 | $79 | $120 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $52 | $99 | $141 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $64 | $85 | $126 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $27 | $115 | $181 |
| 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 | $9 | $11 | $11 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $10 | $43 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $456 | $753 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $87 | $184 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $58 | $107 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $538 | $1,005 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $5,471 | $9,052 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $209 | $305 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $216 | $2,184 | $3,169 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $40 | $149 | $210 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $275 | $549 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $199 | $327 | $456 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $32 | $167 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $70 | $244 | $466 |
| Septoplasty CPT 30520 • ENT | $493 | $617 | $700 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $42 | $98 | $155 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $14 | $147 | $222 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $27 | $158 | $273 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $58 | $267 | $455 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $85 | $288 | $423 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $198 | $206 | $209 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $42 | $128 | $292 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $80 | $249 | $417 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $119 | $162 | $206 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $51 | $234 | $337 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $42 | $138 | $329 |