| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $43 | $81 | $137 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $56 | $112 | $219 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $20 | $47 | $95 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $66 | $113 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $70 | $148 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $65 | $108 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $80 | $119 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $108 | $145 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $123 | $162 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $64 | $100 | $133 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $110 | $183 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $182 | $322 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $169 | $225 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $152 | $191 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $41 | $66 | $116 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $51 | $70 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $5 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $100 | $136 | $162 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $61 | $105 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $90 | $125 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $92 | $129 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $47 | $101 | $171 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $16 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $5 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $6 | $40 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $29 | $74 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $56 | $335 | $850 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $22 | $223 | $753 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $43 | $117 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $70 | $842 | $3,056 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $75 | $2,948 | $6,161 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $22 | $68 | $207 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $1,546 | $4,534 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $176 | $231 | $287 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $399 | $775 | $989 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $327 | $415 | $532 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $152 | $188 | $221 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $166 | $275 | $395 |
| Septoplasty CPT 30520 • ENT | $478 | $608 | $735 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $90 | $168 | $241 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $59 | $140 | $206 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $94 | $183 | $276 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $224 | $380 | $615 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $296 | $391 | $459 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $167 | $188 | $219 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $244 | $290 | $361 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $222 | $412 | $582 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $81 | $156 | $206 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $277 | $323 | $414 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $289 | $338 | $432 |