| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $62 | $134 | $226 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $136 | $215 | $274 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $65 | $152 | $226 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $88 | $190 | $279 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $66 | $117 | $168 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $41 | $117 | $193 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $114 | $203 | $287 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $65 | $161 | $252 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $71 | $89 | $107 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $125 | $221 | $311 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $112 | $192 | $272 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $213 | $372 | $531 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $152 | $384 | $576 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $186 | $186 | $186 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $44 | $96 | $178 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $44 | $69 | $113 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $27 | $55 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $64 | $178 | $309 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $104 | $170 | $256 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $81 | $230 | $304 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $67 | $118 | $170 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $165 | $194 | $223 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $13 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $36 | $48 | $54 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $59 | $68 | $78 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $63 | $78 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $72 | $126 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $8 | $10 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $106 | $373 | $640 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $953 | $3,191 | $5,428 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $30 | $111 | $193 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $214 | $1,532 | $2,235 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $194 | $257 | $320 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $774 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $421 | $566 | $686 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $176 | $225 | $249 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $112 | $573 | $1,016 |
| Septoplasty CPT 30520 • ENT | $596 | $941 | $1,446 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $219 | $274 | $329 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $81 | $274 | $481 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $313 | $459 | $599 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $265 | $456 | $646 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $388 | $608 | $947 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $192 | $376 | $467 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $44 | $267 | $548 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $64 | $475 | $871 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $168 | $310 | $444 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $283 | $457 | $685 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $44 | $286 | $521 |