| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $4 | $108 | $200 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $8 | $177 | $394 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $5 | $115 | $257 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $35 | $89 | $131 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $17 | $109 | $269 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $31 | $123 | $296 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $42 | $101 | $213 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $26 | $179 | $397 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $42 | $143 | $294 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $42 | $133 | $269 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $51 | $239 | $502 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $90 | $233 | $377 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $99 | $311 | $622 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $172 | $344 | $516 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $20 | $118 | $292 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $7 | $83 | $170 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $14 | $42 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $42 | $118 | $252 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $149 | $287 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $17 | $155 | $336 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $13 | $133 | $322 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $14 | $195 | $435 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $6 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $11 | $55 | $96 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $7 | $49 | $117 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $66 | $72 | $75 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $113 | $184 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $9 | $11 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $88 | $616 | $1,005 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $769 | $3,576 | $9,052 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $26 | $120 | $304 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,932 | $2,492 | $3,168 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $99 | $193 | $280 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $55 | $446 | $733 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $60 | $334 | $608 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $16 | $143 | $254 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $350 | $624 | $1,117 |
| Septoplasty CPT 30520 • ENT | $493 | $955 | $2,141 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $49 | $369 | $689 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $44 | $303 | $592 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $205 | $355 | $503 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $288 | $653 | $1,382 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $85 | $509 | $1,019 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $21 | $266 | $567 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $42 | $307 | $836 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $42 | $500 | $1,190 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $42 | $302 | $618 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $236 | $504 | $938 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $42 | $429 | $982 |