| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $9 | $69 | $129 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $159 | $200 | $242 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $7 | $62 | $102 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $17 | $29 | $41 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $101 | $167 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $8 | $59 | $89 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $88 | $103 | $118 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $9 | $43 | $80 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $41 | $95 | $131 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $92 | $159 | $226 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $138 | $162 | $185 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $41 | $150 | $365 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $126 | $158 | $190 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $31 | $116 | $201 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $10 | $94 | $179 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $39 | $63 | $87 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $4 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $121 | $140 | $159 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $82 | $84 | $86 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $60 | $96 | $133 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $15 | $52 | $89 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $8 | $133 | $258 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $7 | $10 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $4 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $28 | $46 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $26 | $33 | $38 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $305 | $481 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $87 | $125 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $25 | $35 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $264 | $641 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $3,760 | $5,354 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $55 | $135 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $668 | $1,585 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $22 | $115 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $100 | $365 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $285 | $334 | $384 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $30 | $100 | $169 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $62 | $115 | $169 |
| Septoplasty CPT 30520 • ENT | $538 | $573 | $609 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $53 | $138 | $223 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $185 | $246 | $307 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $86 | $141 | $195 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $375 | $404 | $432 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $37 | $279 | $521 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $42 | $181 | $290 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $62 | $168 | $274 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $392 | $420 | $462 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $106 | $145 | $197 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $45 | $258 | $471 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $66 | $188 | $311 |