| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $136 | $225 | $277 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $30 | $200 | $326 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $44 | $109 | $251 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $12 | $124 | $197 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $20 | $75 | $170 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $16 | $156 | $295 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $60 | $93 | $166 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $29 | $151 | $277 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $52 | $90 | $114 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $67 | $96 | $125 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $18 | $97 | $176 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $212 | $406 | $599 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $34 | $140 | $221 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $11 | $96 | $181 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $44 | $89 | $179 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $9 | $81 | $198 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $21 | $44 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $16 | $115 | $209 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $42 | $100 | $150 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $11 | $146 | $341 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $124 | $156 | $187 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $31 | $88 | $144 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $6 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $29 | $41 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $38 | $79 | $160 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $296 | $481 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $27 | $82 | $124 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $20 | $52 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $160 | $481 | $642 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $368 | $3,245 | $5,353 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $118 | $192 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $142 | $1,280 | $2,114 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $108 | $202 | $296 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $249 | $705 | $1,162 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $64 | $170 | $276 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $35 | $152 | $268 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $96 | $174 | $252 |
| Septoplasty CPT 30520 • ENT | $154 | $602 | $1,051 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $38 | $240 | $442 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $33 | $91 | $148 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $86 | $249 | $411 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $375 | $377 | $379 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $252 | $300 | $348 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $44 | $296 | $651 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $143 | $188 | $233 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $44 | $188 | $332 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $22 | $79 | $171 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $224 | $230 | $235 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $49 | $270 | $491 |