| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $11 | $57 | $109 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $99 | $127 | $151 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $36 | $39 | $41 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $41 | $78 | $117 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $4 | $48 | $97 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $41 | $44 | $49 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $41 | $68 | $121 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $16 | $54 | $104 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $41 | $74 | $115 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $21 | $78 | $134 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $41 | $104 | $150 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $128 | $177 | $226 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $140 | $195 | $245 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $75 | $120 | $159 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $4 | $48 | $99 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $41 | $52 | $74 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $17 | $41 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $41 | $98 | $148 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $9 | $57 | $91 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $76 | $89 | $107 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $65 | $66 | $68 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $6 | $106 | $161 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $10 | $13 | $19 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $4 | $5 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $6 | $23 | $37 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $43 | $44 | $44 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $79 | $325 | $512 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $58 | $143 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $36 | $56 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $89 | $95 | $107 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $971 | $4,017 | $6,331 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $30 | $126 | $174 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,226 | $2,243 | $2,276 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $38 | $162 | $250 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $396 | $585 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $82 | $256 | $429 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $41 | $141 | $203 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $71 | $291 | $445 |
| Septoplasty CPT 30520 • ENT | $100 | $411 | $635 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $41 | $74 | $139 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $41 | $89 | $158 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $22 | $152 | $266 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $22 | $175 | $282 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $162 | $300 | $414 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $41 | $109 | $204 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $39 | $184 | $328 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $41 | $215 | $523 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $12 | $83 | $195 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $41 | $197 | $301 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $260 | $286 | $313 |