| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $47 | $120 | $174 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $59 | $140 | $219 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $71 | $149 | $265 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $79 | $151 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $75 | $132 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $86 | $160 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $107 | $175 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $103 | $190 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $134 | $232 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $190 | $258 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $64 | $124 | $212 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $115 | $262 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $79 | $182 | $349 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $275 | $376 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $222 | $308 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $36 | $99 | $169 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $21 | $54 | $111 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $20 | $58 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $125 | $218 | $359 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $102 | $146 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $118 | $199 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $85 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $76 | $123 | $160 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $22 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $7 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $5 | $26 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $52 | $74 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $82 | $437 | $876 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $19 | $60 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $48 | $97 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $105 | $323 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $958 | $5,962 | $13,615 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $33 | $186 | $409 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $361 | $2,469 | $3,711 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $211 | $295 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $904 | $1,121 | $1,371 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $401 | $552 | $686 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $111 | $231 | $316 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $330 | $484 | $628 |
| Septoplasty CPT 30520 • ENT | $478 | $747 | $887 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $156 | $214 | $339 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $58 | $167 | $283 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $139 | $278 | $469 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $284 | $428 | $683 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $263 | $579 | $947 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $129 | $239 | $318 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $330 | $418 | $512 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $527 | $668 | $816 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $189 | $233 | $274 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $337 | $410 | $447 |