| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $41 | $69 | $97 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $22 | $70 | $117 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $27 | $34 | $44 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $5 | $49 | $93 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $20 | $67 | $100 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $16 | $72 | $109 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $53 | $90 | $119 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $29 | $97 | $145 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $24 | $91 | $159 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $19 | $63 | $107 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $92 | $93 | $94 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $115 | $124 | $132 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $125 | $176 | $226 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $11 | $54 | $97 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $44 | $58 | $85 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $9 | $37 | $61 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $17 | $44 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $61 | $91 | $121 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $58 | $86 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $73 | $87 | $101 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $62 | $75 | $89 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $9 | $67 | $125 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $6 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $19 | $38 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $28 | $32 | $38 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $45 | $48 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $49 | $124 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $21 | $53 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $51 | $444 | $642 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $437 | $3,269 | $5,353 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $117 | $192 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,154 | $1,794 | $2,114 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $22 | $98 | $174 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $100 | $374 | $525 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $285 | $301 | $318 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $141 | $159 | $177 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $34 | $126 | $219 |
| Septoplasty CPT 30520 • ENT | $499 | $519 | $538 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $35 | $73 | $111 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $10 | $79 | $148 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $86 | $105 | $123 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $50 | $187 | $325 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $174 | $213 | $252 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $44 | $126 | $194 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $206 | $246 | $285 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $203 | $301 | $405 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $15 | $81 | $148 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $224 | $230 | $235 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $164 | $199 | $233 |