| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $24 | $170 | $316 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $13 | $200 | $386 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $10 | $31 | $52 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $14 | $159 | $303 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $53 | $53 | $53 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $12 | $26 | $40 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $26 | $26 | $26 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $77 | $77 | $77 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $89 | $89 | $89 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $84 | $84 | $84 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $63 | $276 | $489 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $83 | $83 | $83 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $25 | $313 | $601 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $13 | $13 | $13 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $31 | $31 | $31 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $9 | $9 | $9 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $23 | $40 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $17 | $95 | $172 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $12 | $144 | $276 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $15 | $169 | $323 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $25 | $25 | $25 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $42 | $42 | $42 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $13 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $8 | $9 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $28 | $39 | $51 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $476 | $556 | $636 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $143 | $143 | $144 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $19 | $34 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $492 | $571 | $649 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $367 | $4,067 | $7,767 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $24 | $63 | $101 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $167 | $993 | $1,820 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $44 | $44 | $44 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $33 | $182 | $330 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $96 | $96 | $96 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $20 | $20 | $20 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $210 | $210 | $210 |
| Septoplasty CPT 30520 • ENT | $563 | $563 | $563 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $71 | $71 | $71 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $9 | $9 | $9 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $19 | $19 | $19 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $262 | $262 | $262 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $40 | $40 | $40 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $166 | $189 | $212 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $310 | $310 | $310 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $64 | $64 | $64 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $28 | $28 | $28 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $301 | $301 | $301 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $124 | $124 | $124 |