| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $44 | $74 | $104 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $19 | $73 | $127 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $31 | $57 | $83 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $77 | $89 | $102 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $17 | $17 | $17 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $4 | $4 | $4 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $52 | $52 | $52 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $95 | $95 | $95 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $45 | $76 | $107 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $80 | $80 | $80 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $16 | $89 | $163 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $196 | $196 | $196 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $149 | $180 | $212 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $86 | $86 | $86 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $21 | $21 | $21 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $5 | $5 | $5 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $45 | $45 | $45 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $65 | $65 | $65 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $19 | $56 | $93 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $52 | $81 | $111 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $56 | $56 | $56 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $54 | $89 | $123 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $28 | $47 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $21 | $24 | $27 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $266 | $310 | $354 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $55 | $100 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $32 | $32 | $33 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $309 | $361 | $412 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $399 | $2,197 | $3,994 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $140 | $140 | $141 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $158 | $872 | $1,587 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $17 | $96 | $174 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $68 | $68 | $68 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $189 | $189 | $189 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $16 | $86 | $157 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $265 | $322 | $378 |
| Septoplasty CPT 30520 • ENT | $540 | $540 | $541 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $39 | $39 | $39 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $178 | $178 | $178 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $21 | $122 | $223 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $45 | $144 | $243 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $54 | $205 | $356 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $26 | $101 | $176 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $57 | $169 | $282 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $90 | $90 | $90 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $17 | $17 | $17 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $45 | $157 | $269 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $45 | $45 | $45 |