| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $165 | $214 | $294 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $205 | $257 | $343 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $53 | $140 | $223 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $161 | $201 | $268 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $82 | $156 | $233 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $166 | $227 | $260 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $127 | $197 | $284 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $105 | $177 | $219 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $115 | $195 | $242 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $142 | $220 | $314 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $192 | $287 | $388 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $146 | $258 | $324 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $227 | $380 | $568 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $289 | $373 | $479 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $153 | $190 | $254 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $74 | $88 | $100 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $13 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $154 | $244 | $347 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $64 | $124 | $159 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $123 | $162 | $186 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $167 | $195 | $234 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $92 | $140 | $227 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $11 | $14 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $5 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $26 | $84 | $158 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $6 | $70 | $193 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $113 | $486 | $699 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $28 | $101 | $219 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $12 | $20 | $34 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $144 | $482 | $955 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $995 | $1,811 | $3,122 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $47 | $141 | $277 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $496 | $3,525 | $7,319 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $337 | $488 | $636 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $589 | $944 | $1,260 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $438 | $599 | $912 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $187 | $301 | $423 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $175 | $519 | $967 |
| Septoplasty CPT 30520 • ENT | $900 | $1,114 | $1,501 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $225 | $350 | $508 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $142 | $221 | $276 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $148 | $282 | $358 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $238 | $465 | $613 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $445 | $610 | $883 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $239 | $250 | $263 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $352 | $445 | $619 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $501 | $524 | $552 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $240 | $272 | $303 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $392 | $495 | $692 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $409 | $436 | $482 |