| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $19 | $69 | $118 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $52 | $74 | $96 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $11 | $49 | $87 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $54 | $84 | $114 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $11 | $55 | $99 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $41 | $53 | $66 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $38 | $74 | $110 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $16 | $54 | $92 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $62 | $106 | $150 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $8 | $65 | $123 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $19 | $102 | $185 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $34 | $124 | $215 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $124 | $125 | $125 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $30 | $110 | $190 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $6 | $29 | $52 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $51 | $53 | $56 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $1 | $2 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $14 | $75 | $137 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $12 | $55 | $97 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $72 | $85 | $99 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $15 | $58 | $101 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $31 | $44 | $58 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $13 | $22 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $8 | $18 | $29 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $26 | $41 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $212 | $384 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $79 | $146 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $30 | $57 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $51 | $70 | $89 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $2,389 | $4,254 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $129 | $244 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,154 | $1,498 | $1,843 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $156 | $182 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $396 | $513 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $41 | $163 | $285 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $25 | $83 | $141 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $157 | $202 | $247 |
| Septoplasty CPT 30520 • ENT | $38 | $323 | $609 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $21 | $67 | $113 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $56 | $60 | $63 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $88 | $154 | $221 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $115 | $221 | $327 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $245 | $279 | $313 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $17 | $94 | $171 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $46 | $149 | $251 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $263 | $298 | $333 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $104 | $110 | $117 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $134 | $203 | $273 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $186 | $235 | $284 |