| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $62 | $179 | $272 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $137 | $205 | $244 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $165 | $199 | $226 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $203 | $236 | $256 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $44 | $142 | $213 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $106 | $137 | $193 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $209 | $254 | $287 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $65 | $246 | $345 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $71 | $197 | $268 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $39 | $164 | $227 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $183 | $300 | $416 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $137 | $233 | $330 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $102 | $431 | $576 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $278 | $278 | $278 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $44 | $127 | $217 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $44 | $96 | $163 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $31 | $55 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $91 | $241 | $323 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $85 | $163 | $228 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $271 | $285 | $304 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $108 | $117 | $126 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $147 | $215 | $283 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $20 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $6 | $11 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $86 | $96 | $114 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $76 | $77 | $78 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $139 | $474 | $809 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $31 | $123 | $214 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $18 | $43 | $67 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $187 | $642 | $1,097 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,695 | $5,470 | $9,245 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $53 | $190 | $326 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $596 | $2,612 | $3,623 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $268 | $307 | $345 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,353 | $1,353 | $1,353 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $591 | $675 | $749 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $240 | $266 | $312 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $167 | $696 | $972 |
| Septoplasty CPT 30520 • ENT | $780 | $1,152 | $1,388 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $303 | $316 | $329 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $81 | $329 | $457 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $365 | $456 | $533 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $575 | $596 | $617 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $407 | $712 | $905 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $447 | $461 | $467 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $167 | $477 | $718 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $871 | $1,007 | $1,143 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $64 | $246 | $444 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $361 | $532 | $659 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $521 | $603 | $684 |