| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $10 | $116 | $233 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $127 | $179 | $282 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $16 | $93 | $182 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $45 | $83 | $103 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $17 | $46 | $76 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $45 | $110 | $212 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $105 | $169 | $233 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $19 | $109 | $198 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $70 | $190 | $311 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $11 | $103 | $253 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $78 | $201 | $361 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $39 | $171 | $429 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $22 | $182 | $313 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $45 | $168 | $375 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $4 | $96 | $187 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $23 | $62 | $100 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $6 | $11 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $44 | $93 | $190 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $12 | $104 | $207 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $84 | $147 | $246 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $56 | $81 | $131 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $25 | $92 | $129 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $16 | $32 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $6 | $11 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $36 | $62 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $27 | $52 | $101 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $35 | $175 | $354 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $47 | $100 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $15 | $25 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $181 | $301 | $412 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,642 | $3,210 | $3,995 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $69 | $141 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $577 | $1,118 | $1,586 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $174 | $228 | $334 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $683 | $997 | $1,310 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $378 | $494 | $725 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $157 | $206 | $302 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $45 | $419 | $834 |
| Septoplasty CPT 30520 • ENT | $45 | $591 | $1,187 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $29 | $144 | $260 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $89 | $221 | $394 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $223 | $313 | $491 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $243 | $339 | $530 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $45 | $393 | $777 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $88 | $216 | $385 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $212 | $415 | $617 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $45 | $454 | $980 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $63 | $214 | $365 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $54 | $296 | $564 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $197 | $391 | $585 |