| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $38 | $95 | $200 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $54 | $150 | $242 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $74 | $158 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $21 | $35 | $54 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $65 | $83 | $105 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $87 | $100 | $114 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $61 | $73 | $85 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $55 | $129 | $171 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $30 | $86 | $117 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $92 | $146 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $21 | $110 | $199 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $34 | $75 | $149 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $91 | $165 | $238 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $22 | $75 | $128 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $35 | $43 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $49 | $77 | $106 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $4 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $76 | $124 | $172 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $86 | $116 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $97 | $132 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $25 | $55 | $84 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $131 | $137 | $142 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $17 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $26 | $41 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $28 | $44 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $348 | $518 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $53 | $134 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $7 | $8 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $51 | $278 | $695 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $2,468 | $6,054 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $75 | $182 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $182 | $1,038 | $1,821 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $44 | $127 | $210 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $90 | $255 | $419 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $48 | $434 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $100 | $208 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $184 | $207 | $231 |
| Septoplasty CPT 30520 • ENT | $48 | $371 | $693 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $40 | $101 | $162 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $29 | $86 | $144 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $126 | $144 | $163 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $46 | $183 | $320 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $254 | $290 | $326 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $40 | $131 | $186 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $40 | $154 | $267 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $391 | $409 | $428 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $73 | $109 | $145 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $178 | $238 | $297 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $248 | $279 | $311 |