| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $4 | $41 | $77 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $50 | $72 | $94 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $14 | $38 | $55 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $17 | $50 | $83 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $3 | $63 | $152 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $22 | $79 | $176 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $24 | $64 | $125 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $44 | $92 | $161 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $24 | $147 | $257 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $27 | $93 | $160 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $16 | $157 | $298 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $132 | $165 | $231 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $170 | $276 | $382 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $189 | $249 | $309 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $33 | $80 | $163 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $31 | $54 | $82 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $18 | $44 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $9 | $115 | $222 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $60 | $116 | $172 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $15 | $109 | $203 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $25 | $99 | $173 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $47 | $150 | $252 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $6 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $22 | $48 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $28 | $33 | $38 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $48 | $52 | $60 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $23 | $91 | $125 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $33 | $52 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $64 | $206 | $481 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $710 | $3,360 | $5,353 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $20 | $23 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,760 | $1,996 | $2,114 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $32 | $117 | $202 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $498 | $554 | $611 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $159 | $269 | $331 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $35 | $99 | $163 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $67 | $245 | $422 |
| Septoplasty CPT 30520 • ENT | $154 | $548 | $941 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $51 | $199 | $346 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $219 | $270 | $322 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $58 | $230 | $401 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $375 | $376 | $377 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $261 | $381 | $502 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $39 | $121 | $279 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $29 | $220 | $411 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $203 | $394 | $586 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $43 | $99 | $210 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $31 | $238 | $446 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $44 | $185 | $462 |