| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $4 | $84 | $164 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $148 | $173 | $199 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $15 | $36 | $48 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $23 | $91 | $160 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $15 | $37 | $53 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $4 | $59 | $109 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $44 | $95 | $164 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $66 | $119 | $197 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $80 | $150 | $220 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $13 | $108 | $178 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $160 | $172 | $184 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $93 | $146 | $200 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $72 | $146 | $220 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $44 | $131 | $265 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $44 | $94 | $139 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $31 | $54 | $88 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $17 | $44 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $9 | $84 | $199 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $12 | $79 | $147 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $11 | $63 | $115 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $62 | $74 | $87 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $16 | $49 | $83 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $6 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $37 | $46 | $52 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $30 | $36 | $38 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $334 | $481 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $23 | $80 | $124 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $36 | $53 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $46 | $443 | $642 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $422 | $2,103 | $5,353 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $15 | $133 | $192 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $211 | $1,168 | $2,113 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $215 | $241 | $266 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $498 | $651 | $805 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $48 | $267 | $437 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $26 | $121 | $216 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $192 | $387 | $581 |
| Septoplasty CPT 30520 • ENT | $77 | $450 | $823 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $44 | $157 | $302 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $22 | $54 | $87 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $58 | $200 | $342 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $26 | $196 | $365 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $174 | $354 | $534 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $44 | $135 | $264 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $143 | $283 | $424 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $41 | $357 | $674 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $22 | $138 | $254 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $44 | $216 | $388 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $44 | $259 | $405 |