| Paring or cutting benign hyperkeratotic lesion single CPT 11055 • Dermatology | $19 | $75 | $188 |
| Paring or cutting benign hyperkeratotic lesions 2-4 CPT 11056 • Dermatology | $17 | $81 | $213 |
| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $37 | $131 | $286 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $46 | $141 | $326 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $56 | $155 | $403 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $34 | $125 | $264 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $51 | $153 | $314 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $33 | $114 | $275 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $39 | $120 | $300 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $72 | $314 | $1,263 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $90 | $341 | $1,263 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $99 | $233 | $438 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $92 | $197 | $367 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $125 | $349 | $546 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $150 | $478 | $1,263 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $198 | $381 | $616 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $129 | $340 | $561 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $41 | $117 | $292 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $42 | $91 | $169 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $14 | $55 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $84 | $247 | $462 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $55 | $130 | $291 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $72 | $175 | $337 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $57 | $201 | $386 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $47 | $198 | $508 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $13 | $22 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $5 | $37 | $98 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $6 | $45 | $98 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $65 | $334 | $776 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $19 | $146 | $753 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $29 | $71 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $113 | $740 | $3,056 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $85 | $3,232 | $7,402 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $26 | $208 | $423 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $277 | $1,685 | $4,275 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $122 | $352 | $827 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $164 | $801 | $1,291 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $102 | $558 | $976 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $98 | $290 | $758 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $166 | $622 | $1,363 |
| Septoplasty CPT 30520 • ENT | $493 | $1,046 | $1,716 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $144 | $368 | $718 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $59 | $200 | $489 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $204 | $445 | $839 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $217 | $647 | $1,419 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $296 | $725 | $1,521 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $157 | $344 | $561 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $244 | $478 | $829 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $347 | $783 | $1,210 |