| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $4 | $156 | $269 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $95 | $196 | $326 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $106 | $251 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $10 | $161 | $311 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $42 | $150 | $259 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $6 | $152 | $295 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $21 | $126 | $213 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $91 | $191 | $277 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $71 | $206 | $434 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $11 | $183 | $355 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $104 | $305 | $506 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $20 | $221 | $599 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $159 | $255 | $439 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $17 | $175 | $337 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $16 | $107 | $264 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $28 | $86 | $141 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $4 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $13 | $134 | $268 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $60 | $130 | $184 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $56 | $161 | $341 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $56 | $93 | $165 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $19 | $195 | $372 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $22 | $50 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $8 | $17 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $62 | $131 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $27 | $72 | $160 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $35 | $171 | $266 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $27 | $67 | $100 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $14 | $25 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $160 | $294 | $412 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $2,589 | $3,193 | $3,994 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $67 | $105 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,189 | $2,948 | $6,068 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $174 | $215 | $296 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $342 | $729 | $1,162 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $38 | $353 | $643 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $157 | $194 | $268 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $189 | $803 | $1,417 |
| Septoplasty CPT 30520 • ENT | $541 | $1,283 | $2,024 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $59 | $302 | $729 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $178 | $422 | $666 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $21 | $277 | $532 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $122 | $511 | $900 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $36 | $678 | $1,320 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $18 | $282 | $651 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $283 | $665 | $1,047 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $338 | $1,002 | $1,667 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $19 | $362 | $706 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $189 | $639 | $1,089 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $197 | $664 | $1,131 |