| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $96 | $217 | $359 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $83 | $266 | $448 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $196 | $223 | $237 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $238 | $291 | $343 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $77 | $77 | $77 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $38 | $143 | $248 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $112 | $166 | $219 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $92 | $214 | $300 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $139 | $217 | $295 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $274 | $274 | $274 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $342 | $461 | $581 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $41 | $217 | $392 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $347 | $550 | $702 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $195 | $253 | $312 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $46 | $131 | $216 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $76 | $101 | $115 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $9 | $10 | $11 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $41 | $160 | $280 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $185 | $235 | $331 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $175 | $293 | $384 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $250 | $301 | $353 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $73 | $243 | $412 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $11 | $15 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $5 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $33 | $84 | $172 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $38 | $64 | $117 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $48 | $296 | $545 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $39 | $83 | $127 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $12 | $34 | $56 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $896 | $1,023 | $1,149 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,524 | $3,637 | $5,750 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $174 | $291 | $408 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $222 | $2,150 | $4,003 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $266 | $534 | $801 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $904 | $1,193 | $1,482 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $41 | $283 | $411 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $41 | $323 | $690 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $273 | $746 | $1,117 |
| Septoplasty CPT 30520 • ENT | $530 | $1,225 | $1,756 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $128 | $185 | $241 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $98 | $341 | $574 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $439 | $557 | $772 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $755 | $1,010 | $1,264 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $488 | $611 | $734 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $367 | $395 | $410 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $540 | $540 | $540 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $462 | $515 | $569 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $132 | $338 | $500 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $504 | $616 | $725 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $292 | $470 | $647 |