| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $21 | $64 | $108 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $38 | $85 | $131 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $27 | $40 | $53 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $6 | $39 | $72 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $5 | $5 | $5 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $66 | $66 | $66 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $58 | $58 | $58 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $11 | $44 | $76 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $92 | $92 | $92 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $15 | $15 | $15 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $137 | $137 | $138 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $85 | $85 | $85 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $24 | $105 | $186 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $22 | $22 | $22 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $8 | $8 | $8 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $9 | $9 | $9 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $1 | $1 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $14 | $14 | $14 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $40 | $63 | $86 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $51 | $76 | $101 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $75 | $75 | $75 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $14 | $99 | $185 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $21 | $21 | $22 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $5 | $5 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $38 | $38 | $39 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $10 | $32 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $64 | $354 | $643 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $109 | $127 | $145 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $8 | $47 | $86 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $89 | $378 | $667 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $786 | $4,323 | $7,860 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $28 | $153 | $278 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $184 | $1,013 | $1,842 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $155 | $155 | $156 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $224 | $335 | $447 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $311 | $311 | $311 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $25 | $75 | $125 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $36 | $195 | $355 |
| Septoplasty CPT 30520 • ENT | $74 | $282 | $491 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $37 | $37 | $37 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $79 | $119 | $158 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $23 | $147 | $272 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $232 | $232 | $233 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $313 | $365 | $417 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $127 | $148 | $169 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $33 | $140 | $247 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $79 | $79 | $79 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $13 | $69 | $125 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $27 | $147 | $268 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $33 | $157 | $281 |