| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $4 | $109 | $272 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $13 | $93 | $137 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $207 | $220 | $226 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $64 | $141 | $256 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $44 | $109 | $213 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $42 | $86 | $110 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $64 | $131 | $265 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $65 | $234 | $321 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $42 | $180 | $357 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $12 | $205 | $311 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $25 | $151 | $265 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $44 | $284 | $493 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $39 | $179 | $362 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $81 | $257 | $433 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $70 | $126 | $217 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $44 | $93 | $163 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $10 | $19 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $64 | $187 | $277 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $72 | $137 | $236 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $64 | $121 | $187 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $32 | $74 | $126 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $6 | $89 | $136 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $15 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $11 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $11 | $48 | $86 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $21 | $54 | $78 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $139 | $548 | $754 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $31 | $133 | $184 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $18 | $69 | $108 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $187 | $732 | $1,005 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $905 | $3,884 | $9,052 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $53 | $221 | $305 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $317 | $2,487 | $3,975 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $198 | $247 | $345 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $55 | $704 | $1,353 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $686 | $707 | $749 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $160 | $211 | $312 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $112 | $614 | $972 |
| Septoplasty CPT 30520 • ENT | $44 | $717 | $1,388 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $101 | $301 | $500 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $81 | $223 | $457 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $273 | $403 | $571 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $43 | $316 | $617 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $42 | $444 | $905 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $64 | $326 | $467 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $44 | $384 | $718 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $42 | $410 | $1,143 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $158 | $268 | $427 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $337 | $445 | $659 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $42 | $359 | $684 |