| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $19 | $67 | $100 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $61 | $95 | $122 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $12 | $53 | $80 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $14 | $64 | $96 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $8 | $17 | $27 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $77 | $84 | $92 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $61 | $64 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $12 | $41 | $69 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $20 | $62 | $89 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $60 | $65 | $69 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $95 | $127 | $155 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $27 | $90 | $153 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $13 | $104 | $192 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $68 | $76 | $84 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $37 | $40 | $43 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $5 | $24 | $43 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $3 | $4 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $76 | $91 | $105 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $13 | $58 | $87 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $47 | $79 | $102 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $21 | $68 | $106 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $108 | $135 | $149 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $46 | $51 | $60 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $35 | $41 | $49 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $241 | $615 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $62 | $159 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $41 | $68 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $571 | $826 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $4,967 | $7,189 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $146 | $240 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $270 | $642 | $1,385 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $95 | $164 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $108 | $369 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $82 | $212 | $342 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $86 | $142 | $171 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $33 | $164 | $270 |
| Septoplasty CPT 30520 • ENT | $431 | $493 | $615 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $69 | $140 | $205 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $129 | $147 | $178 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $107 | $153 | $234 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $80 | $254 | $400 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $181 | $296 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $121 | $150 | $165 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $36 | $107 | $179 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $52 | $218 | $346 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $120 | $126 | $130 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $26 | $160 | $259 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $27 | $115 | $202 |