| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $63 | $109 | $164 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $79 | $138 | $206 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $71 | $158 | $249 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $76 | $164 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $94 | $200 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $23 | $75 | $173 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $107 | $190 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $41 | $101 | $206 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $145 | $252 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $172 | $280 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $52 | $119 | $230 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $140 | $203 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $235 | $379 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $240 | $408 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $202 | $334 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $49 | $96 | $183 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $60 | $108 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $7 | $15 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $125 | $190 | $260 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $103 | $183 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $32 | $118 | $276 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $102 | $172 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $66 | $185 | $412 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $32 | $57 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $6 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $5 | $41 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $74 | $162 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $143 | $467 | $843 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $20 | $64 | $136 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $32 | $66 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $120 | $370 | $761 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,716 | $11,601 | $26,618 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $35 | $100 | $211 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $371 | $1,058 | $2,402 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $244 | $265 | $287 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $842 | $1,041 | $1,291 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $401 | $540 | $686 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $111 | $158 | $182 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $330 | $427 | $480 |
| Septoplasty CPT 30520 • ENT | $478 | $991 | $1,419 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $70 | $250 | $523 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $80 | $197 | $316 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $139 | $259 | $420 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $179 | $395 | $698 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $459 | $763 | $945 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $219 | $277 | $307 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $314 | $375 | $451 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $527 | $584 | $644 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $189 | $234 | $317 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $337 | $418 | $486 |