| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $4 | $168 | $330 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $5 | $243 | $400 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $53 | $106 | $251 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $8 | $138 | $311 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $11 | $135 | $259 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $25 | $158 | $295 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $45 | $178 | $322 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $8 | $200 | $390 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $17 | $225 | $434 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $10 | $183 | $355 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $14 | $158 | $322 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $34 | $217 | $400 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $140 | $261 | $439 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $14 | $270 | $527 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $23 | $82 | $142 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $9 | $65 | $141 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $5 | $8 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $10 | $204 | $393 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $9 | $133 | $286 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $49 | $144 | $341 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $38 | $93 | $165 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $52 | $134 | $185 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $21 | $31 | $50 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $5 | $10 | $17 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $20 | $28 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $55 | $90 | $160 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $64 | $113 | $212 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $62 | $145 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $16 | $62 | $86 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $160 | $572 | $889 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $786 | $3,745 | $7,860 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $28 | $106 | $209 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,381 | $2,944 | $6,068 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $155 | $202 | $296 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $224 | $693 | $1,162 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $155 | $399 | $643 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $63 | $152 | $268 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $266 | $679 | $1,417 |
| Septoplasty CPT 30520 • ENT | $74 | $863 | $2,024 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $55 | $392 | $729 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $32 | $285 | $666 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $136 | $314 | $532 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $34 | $389 | $900 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $34 | $590 | $1,320 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $25 | $282 | $651 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $330 | $688 | $1,047 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $33 | $602 | $1,667 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $33 | $210 | $510 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $201 | $519 | $1,089 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $140 | $517 | $1,131 |