| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $21 | $59 | $97 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $46 | $78 | $111 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $10 | $27 | $44 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $23 | $32 | $41 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $31 | $58 | $101 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $36 | $73 | $110 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $8 | $74 | $119 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $73 | $99 | $145 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $120 | $125 | $131 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $14 | $61 | $107 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $138 | $145 | $152 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $159 | $168 | $176 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $72 | $131 | $190 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $11 | $51 | $97 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $43 | $62 | $100 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $9 | $40 | $61 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $16 | $44 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $65 | $114 | $156 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $45 | $66 | $86 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $62 | $63 | $63 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $89 | $106 | $124 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $6 | $66 | $125 |
| 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 | $25 | $37 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $27 | $38 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $294 | $481 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $49 | $124 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $5 | $5 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $51 | $199 | $481 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $437 | $2,109 | $5,353 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $133 | $192 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $211 | $984 | $1,585 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $32 | $103 | $174 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $249 | $387 | $525 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $64 | $174 | $285 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $35 | $88 | $141 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $38 | $129 | $219 |
| Septoplasty CPT 30520 • ENT | $499 | $634 | $769 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $51 | $109 | $167 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $148 | $156 | $164 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $34 | $115 | $195 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $75 | $200 | $325 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $252 | $300 | $348 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $19 | $68 | $140 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $29 | $117 | $206 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $81 | $260 | $405 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $43 | $135 | $215 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $224 | $269 | $314 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $233 | $240 | $246 |