| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $39 | $109 | $226 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $112 | $207 | $274 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $28 | $140 | $226 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $90 | $191 | $279 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $78 | $117 | $168 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $37 | $114 | $193 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $93 | $196 | $287 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $65 | $148 | $252 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $71 | $80 | $89 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $78 | $153 | $227 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $95 | $95 | $95 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $116 | $116 | $116 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $152 | $372 | $576 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $98 | $98 | $98 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $44 | $100 | $178 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $44 | $68 | $113 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $15 | $55 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $152 | $309 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $82 | $152 | $256 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $97 | $235 | $304 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $71 | $71 | $71 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $104 | $104 | $104 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $6 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $46 | $64 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $46 | $62 | $78 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $62 | $66 | $69 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $96 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $42 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $82 | $87 | $92 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $730 | $4,400 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $26 | $148 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,808 | $2,376 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $214 | $214 | $214 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $630 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $397 | $558 | $686 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $184 | $259 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $112 | $430 | $741 |
| Septoplasty CPT 30520 • ENT | $496 | $978 | $1,658 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $108 | $322 | $536 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $81 | $258 | $458 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $127 | $376 | $623 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $197 | $636 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $263 | $538 | $790 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $146 | $360 | $467 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $167 | $394 | $646 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $64 | $414 | $871 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $145 | $306 | $469 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $228 | $449 | $709 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $238 | $380 | $521 |