| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $119 | $160 | $201 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $60 | $157 | $245 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $94 | $159 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $112 | $193 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $62 | $95 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $69 | $108 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $54 | $78 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $86 | $142 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $158 | $158 | $158 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $79 | $129 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $175 | $312 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $219 | $219 | $219 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $160 | $309 | $384 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $122 | $221 | $320 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $40 | $51 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $49 | $65 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $12 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $97 | $163 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $103 | $175 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $125 | $179 | $205 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $67 | $100 | $116 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $66 | $158 | $251 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $12 | $19 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $50 | $61 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $33 | $37 | $41 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $54 | $57 | $60 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $78 | $141 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $48 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $78 | $502 | $732 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $704 | $3,539 | $6,373 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $22 | $89 | $223 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $262 | $1,648 | $2,402 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $200 | $204 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $544 | $663 | $783 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $434 | $443 | $452 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $181 | $186 | $188 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $306 | $461 |
| Septoplasty CPT 30520 • ENT | $606 | $827 | $1,047 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $215 | $218 | $220 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $133 | $303 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $226 | $398 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $270 | $351 | $432 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $272 | $396 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $196 | $210 | $217 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $252 | $413 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $328 | $500 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $82 | $134 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $256 | $451 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $165 | $299 |