| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $17 | $62 | $108 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $27 | $79 | $131 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $2 | $44 | $86 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $21 | $46 | $72 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $8 | $47 | $86 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $20 | $20 | $20 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $49 | $49 | $49 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $92 | $92 | $92 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $29 | $29 | $29 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $8 | $50 | $92 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $106 | $121 | $137 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $85 | $85 | $85 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $44 | $115 | $186 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $83 | $83 | $83 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $9 | $9 | $9 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $41 | $54 | $67 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $1 | $2 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $92 | $92 | $92 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $8 | $47 | $86 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $13 | $57 | $101 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $36 | $56 | $75 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $31 | $108 | $185 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $13 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $5 | $6 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $33 | $33 | $34 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $41 | $48 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $561 | $602 | $643 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $79 | $145 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $64 | $75 | $85 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $88 | $378 | $667 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $686 | $4,273 | $7,860 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $24 | $103 | $182 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $184 | $1,297 | $2,410 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $155 | $155 | $156 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $224 | $335 | $447 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $71 | $71 | $71 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $25 | $75 | $125 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $66 | $211 | $355 |
| Septoplasty CPT 30520 • ENT | $124 | $307 | $491 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $115 | $115 | $115 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $63 | $111 | $158 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $257 | $264 | $272 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $116 | $174 | $232 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $59 | $238 | $417 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $145 | $170 | $194 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $330 | $330 | $330 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $53 | $53 | $53 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $138 | $138 | $139 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $27 | $147 | $268 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $120 | $210 |