| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $10 | $71 | $101 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $51 | $79 | $125 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $16 | $51 | $79 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $4 | $60 | $98 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $6 | $32 | $58 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $4 | $37 | $71 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $52 | $75 | $99 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $13 | $67 | $121 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $19 | $57 | $95 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $57 | $71 | $84 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $112 | $142 | $160 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $125 | $167 | $188 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $27 | $122 | $199 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $105 | $114 | $124 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $5 | $42 | $80 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $11 | $34 | $47 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $3 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $58 | $114 | $146 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $8 | $64 | $92 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $7 | $74 | $109 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $65 | $92 | $107 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $5 | $72 | $147 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $11 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $32 | $53 | $79 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $12 | $34 | $48 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $76 | $373 | $639 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $16 | $66 | $165 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $40 | $70 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $85 | $310 | $742 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $584 | $2,996 | $7,472 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $13 | $22 | $31 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $327 | $2,066 | $3,926 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $61 | $158 | $224 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $427 | $601 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $232 | $341 | $411 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $27 | $133 | $202 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $26 | $242 | $421 |
| Septoplasty CPT 30520 • ENT | $96 | $444 | $635 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $40 | $129 | $217 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $47 | $135 | $184 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $157 | $237 | $316 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $178 | $287 | $409 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $237 | $316 | $403 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $35 | $122 | $199 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $52 | $186 | $319 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $55 | $282 | $508 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $36 | $125 | $222 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $57 | $229 | $349 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $148 | $255 | $363 |