| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $54 | $124 | $211 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $8 | $79 | $131 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $34 | $48 | $57 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $6 | $93 | $203 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $6 | $34 | $63 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $5 | $38 | $77 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $12 | $93 | $210 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $22 | $98 | $173 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $92 | $141 | $190 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $53 | $113 | $174 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $34 | $166 | $328 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $17 | $132 | $247 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $93 | $232 | $416 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $9 | $109 | $208 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $34 | $52 | $89 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $9 | $59 | $109 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $6 | $10 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $27 | $141 | $255 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $61 | $111 | $188 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $46 | $123 | $221 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $15 | $97 | $200 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $14 | $102 | $185 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $16 | $22 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $28 | $39 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $39 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $64 | $203 | $482 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $90 | $145 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $8 | $8 | $9 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $84 | $280 | $667 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $751 | $4,835 | $7,860 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $27 | $111 | $278 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,381 | $1,694 | $1,860 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $16 | $135 | $235 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $224 | $437 | $650 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $31 | $250 | $470 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $63 | $126 | $190 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $34 | $226 | $355 |
| Septoplasty CPT 30520 • ENT | $246 | $597 | $1,053 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $34 | $208 | $381 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $158 | $220 | $342 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $31 | $243 | $426 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $116 | $248 | $395 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $313 | $419 | $526 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $85 | $182 | $293 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $33 | $232 | $431 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $79 | $347 | $615 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $13 | $167 | $321 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $188 | $310 | $476 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $196 | $345 | $494 |