| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $37 | $92 | $181 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $46 | $130 | $224 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $56 | $87 | $111 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $63 | $180 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $46 | $75 | $111 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $35 | $102 | $189 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $70 | $170 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $123 | $228 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $189 | $306 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $222 | $348 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $94 | $146 | $256 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $147 | $286 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $186 | $341 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $239 | $440 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $146 | $298 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $47 | $104 | $207 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $83 | $144 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $7 | $13 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $125 | $153 | $185 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $112 | $203 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $78 | $130 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $81 | $104 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $60 | $76 | $103 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $16 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $5 | $31 | $61 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $38 | $65 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $340 | $850 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $19 | $192 | $753 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $56 | $117 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $46 | $250 | $896 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $85 | $2,677 | $6,331 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $15 | $202 | $409 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $361 | $1,734 | $4,534 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $201 | $257 | $358 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $788 | $926 | $1,291 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $401 | $546 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $111 | $199 | $308 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $44 | $491 | $901 |
| Septoplasty CPT 30520 • ENT | $478 | $861 | $1,233 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $99 | $190 | $338 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $80 | $235 | $403 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $88 | $379 | $738 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $308 | $446 | $794 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $44 | $412 | $609 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $211 | $268 | $334 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $208 | $399 | $492 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $582 | $831 | $1,318 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $131 | $194 | $239 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $337 | $461 | $694 |