| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $19 | $58 | $97 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $11 | $64 | $117 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $27 | $77 | $102 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $24 | $59 | $93 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $19 | $46 | $81 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $36 | $47 | $57 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $44 | $67 | $97 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $77 | $84 | $94 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $17 | $74 | $131 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $70 | $99 | $147 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $16 | $84 | $152 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $176 | $206 | $235 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $48 | $119 | $190 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $24 | $90 | $156 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $9 | $31 | $43 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $50 | $52 | $53 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $17 | $44 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $51 | $91 | $121 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $32 | $59 | $86 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $12 | $57 | $101 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $66 | $78 | $89 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $51 | $53 | $56 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $13 | $38 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $28 | $37 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $258 | $373 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $69 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $38 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $51 | $558 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $367 | $2,958 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $81 | $203 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $304 | $1,041 | $1,665 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $43 | $108 | $174 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $100 | $312 | $525 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $48 | $166 | $285 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $33 | $87 | $141 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $122 | $130 | $138 |
| Septoplasty CPT 30520 • ENT | $466 | $483 | $499 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $53 | $132 | $176 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $14 | $81 | $148 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $58 | $126 | $195 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $196 | $260 | $325 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $63 | $158 | $252 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $140 | $166 | $212 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $206 | $258 | $310 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $37 | $165 | $294 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $44 | $71 | $104 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $224 | $254 | $285 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $208 | $256 | $328 |