| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $6 | $53 | $99 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $90 | $104 | $119 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $54 | $78 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $96 | $96 | $96 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $40 | $40 | $40 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $34 | $39 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $7 | $7 | $7 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $40 | $40 | $40 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $14 | $27 | $40 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $40 | $40 | $40 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $23 | $90 | $156 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $62 | $62 | $62 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $40 | $121 | $201 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $32 | $32 | $32 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $40 | $62 | $85 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $5 | $5 | $5 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $2 | $2 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $58 | $87 | $116 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $40 | $65 | $89 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $40 | $73 | $105 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $93 | $93 | $94 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $14 | $76 | $138 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $7 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $10 | $32 | $55 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $31 | $31 | $32 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $307 | $357 | $408 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $87 | $101 | $115 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $38 | $38 | $39 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $470 | $470 | $471 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $3,461 | $4,037 | $4,614 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $16 | $89 | $162 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,374 | $1,603 | $1,833 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $90 | $134 | $179 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $352 | $528 | $704 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $39 | $39 | $39 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $162 | $162 | $162 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $112 | $168 | $223 |
| Septoplasty CPT 30520 • ENT | $75 | $287 | $499 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $40 | $87 | $134 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $27 | $97 | $166 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $32 | $121 | $211 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $40 | $185 | $329 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $204 | $238 | $272 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $76 | $113 | $151 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $223 | $223 | $223 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $40 | $179 | $318 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $107 | $107 | $107 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $24 | $131 | $239 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $25 | $25 | $25 |