| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $6 | $120 | $254 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $12 | $146 | $308 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $40 | $107 | $202 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $45 | $83 | $109 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $40 | $127 | $213 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $132 | $234 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $66 | $132 | $254 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $40 | $175 | $310 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $95 | $220 | $344 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $40 | $125 | $211 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $10 | $189 | $400 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $25 | $165 | $305 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $40 | $192 | $334 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $16 | $177 | $411 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $5 | $60 | $115 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $40 | $72 | $132 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $2 | $4 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $8 | $164 | $320 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $40 | $89 | $137 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $14 | $128 | $265 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $122 | $226 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $12 | $158 | $323 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $6 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $35 | $54 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $24 | $28 | $31 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $289 | $409 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $46 | $115 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $27 | $39 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $47 | $154 | $352 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $461 | $1,883 | $4,614 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $101 | $162 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $183 | $194 | $216 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $18 | $136 | $210 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $106 | $464 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $390 | $423 | $456 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $24 | $125 | $190 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $223 | $509 | $725 |
| Septoplasty CPT 30520 • ENT | $50 | $1,009 | $1,658 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $179 | $384 | $536 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $11 | $200 | $458 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $133 | $424 | $623 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $40 | $540 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $40 | $501 | $790 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $40 | $188 | $374 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $40 | $234 | $551 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $64 | $425 | $786 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $111 | $250 | $389 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $179 | $494 | $709 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $40 | $467 | $740 |