| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $73 | $86 | $104 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $27 | $84 | $127 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $3 | $87 | $202 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $86 | $126 | $191 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $17 | $40 | $64 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $42 | $87 | $175 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $74 | $131 | $190 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $164 | $240 | $316 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $235 | $254 | $269 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $9 | $86 | $164 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $82 | $181 | $299 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $13 | $184 | $354 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $199 | $250 | $327 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $120 | $216 | $312 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $16 | $86 | $156 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $28 | $75 | $112 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $15 | $36 | $48 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $13 | $72 | $158 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $93 | $134 | $169 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $74 | $107 | $135 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $11 | $55 | $97 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $19 | $120 | $218 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $13 | $25 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $5 | $9 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $35 | $49 | $65 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $21 | $43 | $80 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $35 | $59 | $106 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $24 | $75 | $100 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $17 | $33 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $41 | $164 | $309 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,294 | $2,761 | $3,994 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $41 | $95 | $140 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,189 | $1,804 | $3,034 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $26 | $155 | $264 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $68 | $595 | $1,033 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $189 | $381 | $572 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $16 | $137 | $238 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $57 | $378 | $699 |
| Septoplasty CPT 30520 • ENT | $45 | $528 | $998 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $146 | $182 | $218 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $36 | $181 | $328 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $107 | $247 | $411 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $37 | $241 | $444 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $45 | $351 | $651 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $176 | $224 | $321 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $45 | $234 | $516 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $90 | $456 | $822 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $25 | $124 | $222 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $40 | $261 | $474 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $28 | $260 | $492 |