| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $22 | $122 | $228 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $41 | $99 | $142 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $45 | $104 | $179 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $10 | $114 | $220 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $18 | $81 | $189 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $43 | $98 | $209 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $18 | $123 | $228 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $107 | $193 | $279 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $32 | $171 | $309 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $26 | $126 | $253 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $17 | $141 | $225 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $32 | $174 | $280 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $23 | $236 | $458 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $84 | $191 | $372 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $5 | $86 | $202 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $44 | $65 | $100 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $8 | $10 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $94 | $187 | $280 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $15 | $82 | $127 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $24 | $101 | $157 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $21 | $113 | $207 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $10 | $95 | $150 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $11 | $32 | $52 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $33 | $33 | $34 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $43 | $49 | $61 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $82 | $121 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $15 | $35 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $58 | $228 | $546 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $722 | $3,529 | $5,055 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $122 | $174 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,433 | $1,708 | $1,904 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $33 | $153 | $216 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $48 | $432 | $815 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $97 | $274 | $452 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $101 | $161 | $195 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $277 | $297 | $336 |
| Septoplasty CPT 30520 • ENT | $316 | $708 | $1,173 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $28 | $218 | $408 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $26 | $189 | $367 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $124 | $278 | $472 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $235 | $470 | $765 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $309 | $411 | $612 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $26 | $181 | $340 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $26 | $264 | $502 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $274 | $495 | $716 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $116 | $234 | $352 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $269 | $389 | $542 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $37 | $300 | $563 |