| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $59 | $206 | $353 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $194 | $316 | $439 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $84 | $170 | $213 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $254 | $313 | $372 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $129 | $213 | $297 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $126 | $131 | $137 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $238 | $312 | $385 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $205 | $325 | $445 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $76 | $199 | $323 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $126 | $267 | $407 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $252 | $405 | $557 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $274 | $345 | $415 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $316 | $504 | $691 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $248 | $302 | $355 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $72 | $107 | $141 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $35 | $117 | $200 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $17 | $26 | $35 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $35 | $76 | $117 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $133 | $183 | $233 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $368 | $372 | $377 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $148 | $242 | $336 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $203 | $322 | $441 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $7 | $10 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $46 | $76 | $105 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $33 | $61 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $325 | $603 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $88 | $165 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $28 | $51 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $422 | $784 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $875 | $4,213 | $7,550 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $29 | $119 | $209 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,385 | $2,266 | $3,146 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $314 | $314 | $314 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,170 | $1,170 | $1,170 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $342 | $342 | $342 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $169 | $169 | $169 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $294 | $651 | $832 |
| Septoplasty CPT 30520 • ENT | $830 | $1,368 | $1,906 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $273 | $446 | $619 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $528 | $535 | $542 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $723 | $730 | $738 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $293 | $760 | $1,227 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $419 | $655 | $891 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $266 | $382 | $497 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $732 | $756 | $779 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $467 | $754 | $1,042 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $111 | $324 | $478 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $355 | $589 | $822 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $859 | $894 | $930 |