| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $4 | $54 | $104 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $5 | $67 | $129 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $21 | $53 | $84 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $17 | $59 | $101 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $17 | $17 | $17 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $68 | $106 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $52 | $52 | $52 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $130 | $130 | $130 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $72 | $72 | $72 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $71 | $71 | $71 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $51 | $107 | $164 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $132 | $132 | $132 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $67 | $136 | $204 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $119 | $119 | $119 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $27 | $27 | $27 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $45 | $45 | $45 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $0 | $0 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $61 | $61 | $61 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $10 | $52 | $94 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $55 | $83 | $110 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $22 | $64 | $107 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $12 | $79 | $145 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $7 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $12 | $31 | $50 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $49 | $49 | $49 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $60 | $357 | $653 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $119 | $138 | $158 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $6 | $7 | $7 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $612 | $633 | $653 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $688 | $3,781 | $6,875 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $25 | $142 | $260 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,996 | $2,432 | $2,869 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $54 | $161 | $269 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $488 | $488 | $488 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $205 | $205 | $205 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $28 | $108 | $187 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $29 | $161 | $292 |
| Septoplasty CPT 30520 • ENT | $506 | $588 | $669 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $15 | $116 | $216 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $63 | $124 | $185 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $78 | $165 | $252 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $25 | $229 | $432 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $317 | $328 | $338 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $177 | $182 | $188 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $52 | $52 | $52 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $42 | $51 | $59 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $13 | $13 | $13 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $43 | $166 | $288 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $151 | $151 | $151 |