| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $44 | $173 | $330 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $123 | $152 | $208 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $67 | $76 | $81 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $50 | $103 | $163 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $64 | $84 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $34 | $69 | $156 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $50 | $113 | $166 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $50 | $124 | $202 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $129 | $167 | $225 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $50 | $85 | $155 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $93 | $126 | $155 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $167 | $174 | $178 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $230 | $278 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $527 | $527 | $527 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $37 | $139 | $264 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $44 | $89 | $198 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $9 | $26 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $74 | $146 | $209 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $70 | $138 | $225 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $87 | $159 | $341 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $60 | $81 | $92 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $48 | $120 | $189 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $31 | $31 | $31 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $9 | $9 | $9 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $15 | $52 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $33 | $35 | $37 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $65 | $277 | $648 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $27 | $93 | $126 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $14 | $49 | $72 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $87 | $114 | $169 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $2,589 | $2,589 | $2,589 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $27 | $32 | $42 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $3,356 | $3,356 | $3,356 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $215 | $227 | $249 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $498 | $719 | $1,162 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $318 | $392 | $541 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $177 | $259 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $50 | $280 | $484 |
| Septoplasty CPT 30520 • ENT | $643 | $674 | $697 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $230 | $237 | $252 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $50 | $115 | $197 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $50 | $382 | $833 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $241 | $355 | $453 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $321 | $654 | $1,320 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $178 | $208 | $268 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $262 | $320 | $434 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $370 | $804 | $1,667 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $132 | $323 | $706 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $50 | $233 | $367 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $296 | $575 | $1,131 |