| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $11 | $64 | $118 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $19 | $37 | $56 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $41 | $52 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $11 | $62 | $114 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $60 | $92 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $49 | $75 | $101 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $63 | $90 | $118 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $80 | $107 | $133 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $40 | $100 | $159 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $15 | $56 | $97 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $46 | $116 | $185 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $171 | $186 | $200 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $40 | $96 | $153 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $15 | $62 | $110 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $9 | $53 | $96 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $44 | $45 | $47 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $3 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $40 | $94 | $148 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $53 | $56 | $59 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $40 | $59 | $77 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $10 | $59 | $108 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $13 | $77 | $141 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $14 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $29 | $37 | $46 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $35 | $43 | $51 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $55 | $64 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $60 | $108 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $45 | $85 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $41 | $453 | $866 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $350 | $563 | $777 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $130 | $244 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $924 | $1,145 | $1,366 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $139 | $180 | $221 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $181 | $300 | $420 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $72 | $207 | $342 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $30 | $71 | $112 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $66 | $111 | $157 |
| Septoplasty CPT 30520 • ENT | $48 | $307 | $566 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $10 | $68 | $126 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $29 | $98 | $168 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $76 | $148 | $221 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $40 | $204 | $368 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $68 | $187 | $307 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $40 | $105 | $171 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $134 | $184 | $233 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $214 | $273 | $333 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $15 | $97 | $180 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $119 | $186 | $253 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $248 | $256 | $264 |