| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $53 | $257 | $461 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $13 | $112 | $212 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $5 | $141 | $367 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $6 | $225 | $444 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $6 | $195 | $385 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $36 | $170 | $424 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $6 | $233 | $460 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $60 | $309 | $559 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $9 | $314 | $620 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $8 | $192 | $376 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $69 | $254 | $438 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $18 | $427 | $836 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $91 | $338 | $586 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $69 | $223 | $455 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $6 | $149 | $402 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $40 | $138 | $237 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $11 | $22 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $22 | $244 | $575 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $82 | $163 | $244 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $33 | $256 | $479 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $50 | $151 | $252 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $27 | $82 | $138 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $17 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $4 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $8 | $21 | $28 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $25 | $39 | $51 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $31 | $328 | $477 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $86 | $143 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $50 | $85 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $42 | $259 | $649 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $350 | $5,295 | $7,767 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $12 | $73 | $183 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $924 | $1,521 | $1,821 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $44 | $115 | $185 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $181 | $319 | $458 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $240 | $269 | $297 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $30 | $76 | $123 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $40 | $340 | $641 |
| Septoplasty CPT 30520 • ENT | $40 | $1,196 | $2,352 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $15 | $271 | $527 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $13 | $361 | $709 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $126 | $348 | $570 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $40 | $786 | $1,532 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $51 | $608 | $1,165 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $40 | $285 | $648 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $54 | $503 | $952 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $40 | $488 | $1,359 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $29 | $260 | $490 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $36 | $539 | $1,043 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $40 | $564 | $1,089 |