| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $43 | $98 | $137 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $56 | $121 | $219 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $20 | $50 | $99 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $72 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $64 | $148 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $65 | $113 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $78 | $124 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $107 | $152 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $137 | $167 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $95 | $139 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $119 | $193 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $184 | $322 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $174 | $237 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $161 | $198 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $66 | $116 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $52 | $70 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $8 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $125 | $163 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $62 | $105 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $90 | $128 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $95 | $129 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $47 | $109 | $171 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $15 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $5 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $6 | $41 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $41 | $74 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $56 | $394 | $850 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $22 | $186 | $753 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $43 | $117 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $70 | $792 | $3,056 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $75 | $4,011 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $22 | $124 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $2,095 | $4,534 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $176 | $263 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $399 | $828 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $327 | $548 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $152 | $237 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $265 | $395 |
| Septoplasty CPT 30520 • ENT | $478 | $615 | $735 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $90 | $176 | $241 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $141 | $206 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $181 | $276 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $224 | $380 | $615 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $336 | $459 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $30 | $153 | $219 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $258 | $361 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $372 | $582 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $146 | $206 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $277 | $414 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $260 | $432 |