| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $4 | $57 | $110 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $30 | $43 | $56 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $10 | $47 | $87 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $9 | $25 | $41 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $3 | $51 | $99 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $55 | $72 | $89 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $11 | $65 | $110 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $44 | $78 | $144 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $100 | $130 | $160 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $19 | $83 | $134 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $18 | $85 | $152 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $20 | $75 | $130 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $101 | $127 | $153 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $44 | $81 | $118 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $44 | $64 | $104 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $31 | $46 | $57 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $17 | $44 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $9 | $65 | $121 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $47 | $63 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $93 | $97 | $101 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $25 | $57 | $89 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $13 | $69 | $125 |
| 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 | $27 | $48 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $23 | $38 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $152 | $361 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $86 | $125 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $5 | $5 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $394 | $641 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $350 | $3,239 | $5,353 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $11 | $100 | $144 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $173 | $833 | $2,113 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $43 | $126 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $75 | $401 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $32 | $192 | $317 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $88 | $100 | $112 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $29 | $138 | $248 |
| Septoplasty CPT 30520 • ENT | $44 | $326 | $609 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $44 | $117 | $190 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $60 | $64 | $69 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $58 | $90 | $123 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $44 | $116 | $189 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $252 | $257 | $261 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $44 | $136 | $194 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $57 | $145 | $233 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $61 | $177 | $294 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $108 | $118 | $127 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $31 | $152 | $273 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $33 | $120 | $284 |