| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $38 | $113 | $165 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $81 | $127 | $156 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $48 | $69 | $101 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $122 | $152 | $206 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $47 | $98 | $147 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $65 | $124 | $183 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $46 | $107 | $144 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $111 | $146 | $176 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $57 | $146 | $215 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $121 | $170 | $235 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $152 | $178 | $197 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $228 | $257 | $304 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $251 | $327 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $46 | $190 | $268 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $76 | $108 | $128 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $61 | $71 | $78 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $13 | $40 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $162 | $180 | $208 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $86 | $103 | $114 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $101 | $134 | $172 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $89 | $110 | $147 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $91 | $194 | $319 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $13 | $20 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $35 | $55 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $51 | $96 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $48 | $167 | $492 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $13 | $14 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $6 | $7 | $8 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $67 | $248 | $751 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $594 | $712 | $776 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $16 | $30 | $48 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $195 | $675 | $1,154 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $219 | $235 | $271 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $507 | $705 | $1,394 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $334 | $441 | $788 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $154 | $176 | $189 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $87 | $316 | $454 |
| Septoplasty CPT 30520 • ENT | $609 | $744 | $865 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $167 | $211 | $247 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $49 | $181 | $252 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $123 | $261 | $397 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $102 | $393 | $561 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $364 | $413 | $476 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $88 | $195 | $249 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $40 | $282 | $425 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $294 | $426 | $571 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $40 | $143 | $203 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $224 | $310 | $394 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $46 | $254 | $410 |