| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $15 | $123 | $254 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $24 | $152 | $308 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $40 | $64 | $79 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $33 | $126 | $246 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $16 | $49 | $83 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $38 | $114 | $234 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $52 | $109 | $167 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $44 | $128 | $213 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $15 | $125 | $235 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $67 | $175 | $283 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $77 | $162 | $249 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $131 | $298 | $465 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $267 | $502 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $11 | $134 | $258 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $46 | $135 | $225 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $11 | $61 | $110 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $7 | $12 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $81 | $168 | $320 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $43 | $90 | $137 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $16 | $97 | $168 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $104 | $145 | $226 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $96 | $189 | $323 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $13 | $16 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $32 | $48 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $194 | $479 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $98 | $165 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $6 | $7 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $330 | $858 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $4,629 | $7,472 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $162 | $258 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,438 | $2,232 | $2,815 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $61 | $165 | $224 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $85 | $454 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $70 | $263 | $456 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $190 | $201 | $212 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $131 | $478 | $725 |
| Septoplasty CPT 30520 • ENT | $447 | $1,142 | $1,658 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $14 | $226 | $438 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $31 | $293 | $458 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $50 | $334 | $623 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $36 | $656 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $316 | $593 | $790 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $35 | $166 | $374 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $259 | $405 | $551 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $369 | $578 | $786 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $90 | $269 | $389 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $57 | $454 | $709 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $59 | $324 | $620 |