| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $5 | $51 | $97 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $16 | $67 | $117 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $15 | $60 | $108 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $64 | $79 | $93 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $18 | $41 | $64 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $9 | $49 | $89 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $101 | $152 | $203 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $66 | $157 | $248 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $90 | $121 | $152 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $82 | $95 | $107 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $31 | $91 | $152 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $20 | $112 | $205 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $208 | $226 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $149 | $189 | $213 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $5 | $33 | $51 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $6 | $27 | $48 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $2 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $177 | $216 | $255 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $74 | $127 | $181 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $19 | $115 | $212 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $89 | $106 | $124 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $24 | $84 | $144 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $5 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $31 | $42 | $55 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $28 | $34 | $39 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $32 | $198 | $512 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $55 | $143 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $38 | $57 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $42 | $57 | $67 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $3,801 | $6,565 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $132 | $232 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $948 | $1,383 | $1,615 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $88 | $134 | $181 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $75 | $366 | $525 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $285 | $305 | $326 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $26 | $98 | $169 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $51 | $171 | $291 |
| Septoplasty CPT 30520 • ENT | $167 | $609 | $1,051 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $27 | $128 | $191 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $49 | $134 | $219 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $95 | $145 | $195 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $52 | $216 | $379 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $52 | $152 | $252 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $32 | $137 | $212 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $43 | $111 | $247 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $294 | $313 | $333 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $110 | $141 | $172 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $265 | $305 | $345 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $72 | $175 | $277 |