| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $28 | $76 | $133 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $123 | $128 | $134 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $21 | $75 | $125 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $99 | $171 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $4 | $20 | $35 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $42 | $89 | $156 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $24 | $167 | $309 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $125 | $202 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $129 | $197 | $238 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $12 | $179 | $346 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $125 | $174 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $179 | $189 | $200 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $146 | $278 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $30 | $83 | $177 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $41 | $48 | $55 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $8 | $51 | $88 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $3 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $78 | $135 | $209 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $12 | $115 | $272 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $81 | $145 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $106 | $132 | $169 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $59 | $112 | $164 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $6 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $4 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $28 | $61 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $6 | $23 | $35 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $31 | $44 | $57 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $50 | $121 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $40 | $66 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $51 | $75 | $95 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $584 | $2,161 | $5,165 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $11 | $149 | $234 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $841 | $2,052 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $39 | $130 | $212 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $125 | $273 | $420 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $205 | $338 | $410 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $27 | $126 | $182 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $120 | $194 |
| Septoplasty CPT 30520 • ENT | $30 | $704 | $1,650 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $37 | $69 | $126 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $12 | $83 | $208 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $142 | $351 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $30 | $245 | $662 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $142 | $353 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $124 | $213 | $355 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $57 | $173 | $288 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $448 | $903 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $122 | $300 | $478 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $309 | $764 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $149 | $268 |