| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $6 | $78 | $121 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $5 | $94 | $147 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $34 | $60 | $83 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $23 | $86 | $118 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $8 | $51 | $102 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $4 | $53 | $112 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $42 | $78 | $121 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $26 | $59 | $102 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $42 | $83 | $128 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $44 | $72 | $101 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $119 | $135 | $164 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $146 | $147 | $147 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $43 | $165 | $240 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $26 | $131 | $197 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $42 | $80 | $107 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $5 | $42 | $63 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $14 | $42 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $26 | $89 | $153 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $71 | $95 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $22 | $93 | $127 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $64 | $82 | $110 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $9 | $101 | $157 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $39 | $55 | $64 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $10 | $43 | $72 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $243 | $754 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $57 | $184 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $43 | $107 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $60 | $307 | $1,005 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $3,000 | $9,052 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $166 | $305 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,438 | $2,064 | $2,376 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $99 | $169 | $210 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $55 | $439 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $60 | $304 | $456 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $80 | $143 | $190 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $233 | $325 | $466 |
| Septoplasty CPT 30520 • ENT | $329 | $539 | $657 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $101 | $155 | $209 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $34 | $121 | $222 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $157 | $233 | $329 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $43 | $191 | $288 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $85 | $277 | $423 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $42 | $143 | $209 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $42 | $119 | $263 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $42 | $317 | $534 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $42 | $114 | $186 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $236 | $286 | $337 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $42 | $230 | $351 |