| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $46 | $100 | $131 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $11 | $76 | $152 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $38 | $71 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $18 | $88 | $126 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $16 | $29 | $43 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $9 | $30 | $51 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $60 | $73 | $86 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $114 | $136 | $157 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $17 | $70 | $122 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $14 | $62 | $142 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $24 | $140 | $203 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $29 | $138 | $241 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $48 | $182 | $261 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $92 | $167 | $211 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $36 | $73 | $105 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $53 | $63 | $70 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $3 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $19 | $69 | $158 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $77 | $101 | $116 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $64 | $110 | $138 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $22 | $69 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $31 | $116 | $164 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $12 | $19 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $13 | $35 | $55 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $53 | $56 | $61 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $81 | $430 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $71 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $31 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $92 | $376 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $807 | $2,615 | $6,054 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $27 | $87 | $203 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $346 | $1,889 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $37 | $202 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $102 | $444 | $786 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $80 | $438 | $799 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $167 | $227 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $291 | $350 | $468 |
| Septoplasty CPT 30520 • ENT | $466 | $599 | $666 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $150 | $196 | $242 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $138 | $181 | $221 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $125 | $183 | $250 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $86 | $272 | $431 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $48 | $267 | $436 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $26 | $139 | $216 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $130 | $245 | $347 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $37 | $294 | $550 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $100 | $205 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $57 | $219 | $316 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $194 | $329 |