| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $9 | $75 | $107 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $26 | $90 | $130 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $12 | $58 | $83 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $9 | $107 | $231 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $17 | $96 | $193 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $42 | $96 | $220 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $76 | $157 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $64 | $169 | $292 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $28 | $142 | $324 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $9 | $137 | $266 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $15 | $185 | $376 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $13 | $225 | $437 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $194 | $314 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $26 | $206 | $386 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $37 | $96 | $211 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $42 | $59 | $103 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $8 | $13 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $65 | $161 | $301 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $107 | $212 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $37 | $123 | $249 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $64 | $84 | $125 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $27 | $79 | $136 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $39 | $50 | $64 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $45 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $292 | $753 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $87 | $184 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $58 | $107 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $312 | $1,005 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $6,226 | $9,052 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $184 | $304 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $316 | $1,377 | $2,376 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $198 | $259 | $369 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $82 | $640 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $199 | $327 | $456 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $80 | $179 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $42 | $285 | $466 |
| Septoplasty CPT 30520 • ENT | $493 | $797 | $1,240 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $36 | $224 | $412 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $10 | $199 | $365 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $34 | $205 | $308 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $42 | $378 | $805 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $42 | $366 | $633 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $157 | $239 | $351 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $42 | $243 | $518 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $42 | $296 | $739 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $155 | $256 | $365 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $236 | $377 | $559 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $42 | $290 | $583 |