| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $9 | $63 | $117 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $26 | $86 | $145 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $14 | $53 | $92 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $36 | $75 | $114 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $49 | $49 | $49 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $16 | $16 | $16 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $60 | $60 | $60 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $20 | $20 | $20 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $11 | $11 | $11 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $20 | $77 | $134 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $18 | $101 | $183 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $98 | $98 | $98 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $31 | $129 | $228 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $19 | $19 | $19 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $10 | $10 | $10 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $26 | $26 | $26 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $1 | $1 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $9 | $9 | $9 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $11 | $58 | $106 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $12 | $68 | $123 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $53 | $81 | $108 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $98 | $123 | $147 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $8 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $18 | $66 | $114 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $46 | $55 | $64 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $785 | $797 | $809 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $214 | $223 | $232 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $42 | $75 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $109 | $439 | $768 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $6,358 | $7,802 | $9,245 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $32 | $127 | $221 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $362 | $1,992 | $3,623 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $55 | $161 | $268 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $86 | $86 | $86 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $445 | $445 | $445 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $37 | $138 | $240 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $117 | $196 | $276 |
| Septoplasty CPT 30520 • ENT | $63 | $347 | $631 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $21 | $82 | $142 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $88 | $132 | $175 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $22 | $130 | $238 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $306 | $357 | $408 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $45 | $171 | $296 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $25 | $97 | $168 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $246 | $246 | $246 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $263 | $263 | $263 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $123 | $123 | $123 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $203 | $237 | $270 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $56 | $56 | $56 |