| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $62 | $149 | $226 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $191 | $234 | $274 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $122 | $140 | $165 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $72 | $185 | $279 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $46 | $89 | $168 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $128 | $158 | $193 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $168 | $189 | $209 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $65 | $175 | $252 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $175 | $261 | $384 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $55 | $155 | $227 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $260 | $260 | $260 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $44 | $176 | $309 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $102 | $299 | $576 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $170 | $170 | $170 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $134 | $151 | $178 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $44 | $72 | $113 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $21 | $55 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $176 | $278 | $348 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $85 | $169 | $256 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $117 | $193 | $304 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $82 | $82 | $82 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $175 | $175 | $175 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $14 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $5 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $12 | $29 | $45 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $67 | $72 | $78 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $79 | $273 | $468 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $90 | $161 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $31 | $52 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $84 | $95 | $106 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $961 | $4,123 | $7,284 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $30 | $137 | $244 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,253 | $2,499 | $2,744 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $186 | $191 | $196 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $529 | $652 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $425 | $567 | $686 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $168 | $172 | $177 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $167 | $633 | $1,016 |
| Septoplasty CPT 30520 • ENT | $780 | $1,028 | $1,446 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $62 | $191 | $319 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $81 | $300 | $481 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $299 | $450 | $599 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $371 | $508 | $646 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $407 | $647 | $947 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $55 | $126 | $269 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $64 | $323 | $548 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $44 | $533 | $871 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $44 | $195 | $302 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $361 | $486 | $685 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $416 | $551 | $714 |