| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $25 | $66 | $123 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $31 | $109 | $152 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $41 | $77 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $25 | $89 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $4 | $27 | $39 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $22 | $58 | $108 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $8 | $69 | $118 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $10 | $73 | $142 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $133 | $153 | $168 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $10 | $69 | $129 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $12 | $107 | $193 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $22 | $84 | $146 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $119 | $198 | $237 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $192 | $195 | $198 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $6 | $51 | $96 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $50 | $64 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $3 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $16 | $80 | $144 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $10 | $70 | $109 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $8 | $93 | $128 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $56 | $81 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $76 | $126 | $152 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $12 | $19 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $13 | $45 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $27 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $60 | $341 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $101 | $179 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $52 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $78 | $319 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $704 | $2,764 | $8,072 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $89 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,750 | $2,103 | $2,281 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $184 | $251 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $783 | $899 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $80 | $257 | $434 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $67 | $193 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $87 | $268 | $426 |
| Septoplasty CPT 30520 • ENT | $100 | $457 | $665 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $43 | $132 | $220 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $6 | $97 | $183 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $25 | $191 | $329 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $216 | $306 | $431 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $238 | $317 | $396 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $132 | $168 | $196 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $26 | $170 | $314 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $238 | $500 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $131 | $132 | $134 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $57 | $210 | $288 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $165 | $299 |