| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $8 | $126 | $243 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $10 | $154 | $297 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $40 | $59 | $78 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $10 | $122 | $234 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $59 | $59 | $59 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $18 | $120 | $222 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $10 | $126 | $242 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $43 | $43 | $43 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $14 | $14 | $14 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $109 | $109 | $109 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $50 | $214 | $378 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $40 | $82 | $123 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $20 | $243 | $466 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $32 | $36 | $40 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $7 | $7 | $7 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $11 | $11 | $11 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $1 | $1 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $41 | $41 | $41 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $35 | $123 | $212 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $79 | $164 | $249 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $93 | $93 | $94 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $58 | $98 | $138 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $7 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $10 | $26 | $41 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $62 | $62 | $62 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $41 | $224 | $408 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $63 | $115 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $21 | $39 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $352 | $411 | $471 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $4,614 | $4,614 | $4,614 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $122 | $142 | $162 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $183 | $1,008 | $1,832 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $36 | $107 | $179 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $704 | $704 | $704 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $928 | $928 | $928 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $81 | $122 | $162 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $75 | $317 | $559 |
| Septoplasty CPT 30520 • ENT | $499 | $884 | $1,270 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $76 | $76 | $76 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $83 | $226 | $368 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $42 | $262 | $482 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $40 | $433 | $826 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $54 | $333 | $611 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $151 | $151 | $151 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $33 | $128 | $223 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $32 | $36 | $40 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $15 | $135 | $254 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $48 | $297 | $546 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $124 | $347 | $571 |