| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $23 | $75 | $126 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $8 | $212 | $417 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $3 | $125 | $271 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $37 | $266 | $434 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $79 | $171 | $284 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $11 | $104 | $177 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $87 | $293 | $449 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $114 | $358 | $541 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $112 | $331 | $461 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $71 | $278 | $384 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $89 | $439 | $699 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $29 | $491 | $832 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $178 | $579 | $902 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $122 | $377 | $545 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $6 | $171 | $363 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $46 | $141 | $196 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $6 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $19 | $281 | $452 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $11 | $238 | $401 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $12 | $236 | $476 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $22 | $166 | $310 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $12 | $215 | $418 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $6 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $55 | $64 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $40 | $46 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $52 | $60 | $69 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $96 | $179 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $6 | $7 | $8 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $69 | $498 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $604 | $706 | $807 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $20 | $112 | $203 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $228 | $1,634 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $37 | $129 | $220 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $576 | $795 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $478 | $639 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $33 | $116 | $199 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $58 | $720 | $1,619 |
| Septoplasty CPT 30520 • ENT | $133 | $1,422 | $2,303 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $108 | $511 | $838 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $62 | $334 | $766 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $117 | $587 | $954 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $238 | $815 | $1,182 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $238 | $872 | $1,506 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $279 | $485 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $195 | $701 | $1,195 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $55 | $991 | $1,901 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $19 | $365 | $708 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $199 | $695 | $1,096 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $45 | $669 | $1,137 |