| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $5 | $58 | $123 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $15 | $74 | $152 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $5 | $56 | $86 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $114 | $116 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $28 | $54 | $81 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $22 | $65 | $109 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $7 | $81 | $119 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $89 | $144 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $78 | $83 | $88 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $107 | $127 | $140 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $53 | $120 | $193 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $21 | $118 | $215 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $24 | $150 | $237 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $44 | $88 | $122 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $10 | $35 | $52 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $5 | $35 | $50 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $2 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $94 | $121 | $148 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $6 | $73 | $109 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $100 | $119 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $108 | $115 | $124 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $33 | $112 | $152 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $28 | $48 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $35 | $42 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $219 | $561 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $108 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $46 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $360 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $2,158 | $5,142 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $157 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $974 | $2,411 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $315 | $369 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $823 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $342 | $371 | $400 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $33 | $178 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $96 | $185 | $291 |
| Septoplasty CPT 30520 • ENT | $333 | $499 | $665 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $103 | $153 | $204 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $44 | $136 | $183 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $125 | $190 | $250 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $26 | $215 | $431 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $63 | $211 | $317 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $29 | $121 | $194 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $143 | $174 | $205 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $74 | $216 | $358 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $19 | $83 | $147 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $142 | $233 | $284 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $139 | $233 |