| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $123 | $218 | $278 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $11 | $153 | $312 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $62 | $122 | $221 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $24 | $179 | $269 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $38 | $135 | $233 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $8 | $103 | $256 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $45 | $132 | $183 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $153 | $246 | $339 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $112 | $244 | $377 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $101 | $208 | $309 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $16 | $284 | $437 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $98 | $304 | $509 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $22 | $354 | $549 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $198 | $301 | $450 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $79 | $145 | $232 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $9 | $88 | $145 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $20 | $45 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $96 | $223 | $350 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $64 | $179 | $246 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $7 | $188 | $290 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $56 | $151 | $226 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $12 | $126 | $231 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $8 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $44 | $87 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $9 | $19 | $27 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $35 | $157 | $354 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $43 | $100 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $19 | $25 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $41 | $152 | $309 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $954 | $2,981 | $3,995 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $62 | $141 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $158 | $1,248 | $2,397 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $174 | $233 | $350 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $683 | $1,023 | $1,371 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $378 | $505 | $759 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $157 | $269 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $265 | $423 | $600 |
| Septoplasty CPT 30520 • ENT | $666 | $1,161 | $1,443 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $18 | $268 | $479 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $62 | $289 | $426 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $250 | $444 | $564 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $432 | $752 | $938 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $71 | $487 | $737 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $253 | $409 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $45 | $302 | $603 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $225 | $616 | $860 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $13 | $204 | $426 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $54 | $432 | $651 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $211 | $445 | $679 |