| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $8 | $84 | $135 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $16 | $96 | $143 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $72 | $84 | $108 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $36 | $80 | $131 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $11 | $24 | $37 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $31 | $47 | $65 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $15 | $67 | $118 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $112 | $130 | $149 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $61 | $93 | $124 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $10 | $67 | $123 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $38 | $120 | $185 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $107 | $177 | $247 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $158 | $192 | $232 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $90 | $113 | $136 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $46 | $48 | $52 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $33 | $44 | $57 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $3 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $13 | $80 | $148 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $8 | $52 | $86 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $96 | $107 | $123 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $38 | $74 | $108 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $28 | $92 | $185 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $12 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $4 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $22 | $33 | $38 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $10 | $29 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $50 | $51 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $56 | $145 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $22 | $57 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $347 | $889 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $4,686 | $7,860 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $141 | $232 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $173 | $1,387 | $1,995 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $155 | $205 | $251 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $45 | $338 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $41 | $163 | $285 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $125 | $130 | $141 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $178 | $242 | $355 |
| Septoplasty CPT 30520 • ENT | $34 | $408 | $699 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $37 | $120 | $204 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $41 | $127 | $181 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $51 | $187 | $272 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $35 | $161 | $232 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $209 | $311 | $417 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $127 | $172 | $196 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $236 | $242 | $247 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $337 | $431 | $526 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $31 | $63 | $120 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $243 | $256 | $268 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $38 | $201 | $284 |