| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $47 | $66 | $102 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $59 | $115 | $199 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $71 | $101 | $159 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $76 | $151 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $75 | $102 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $58 | $76 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $68 | $92 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $118 | $212 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $67 | $138 | $257 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $162 | $284 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $75 | $135 | $236 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $194 | $326 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $201 | $377 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $231 | $405 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $187 | $336 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $49 | $81 | $110 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $61 | $95 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $7 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $125 | $212 | $276 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $73 | $118 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $123 | $221 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $109 | $197 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $76 | $128 | $195 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $16 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $6 | $62 | $96 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $38 | $92 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $45 | $92 | $143 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $36 | $90 | $165 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $21 | $43 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $162 | $415 | $720 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $75 | $2,042 | $5,165 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $22 | $76 | $181 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $803 | $2,051 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $212 | $360 | $689 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $624 | $832 | $989 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $330 | $625 | $952 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $182 | $304 | $631 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $178 | $366 | $487 |
| Septoplasty CPT 30520 • ENT | $430 | $629 | $932 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $156 | $246 | $362 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $80 | $166 | $282 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $217 | $351 | $436 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $276 | $410 | $720 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $203 | $419 | $519 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $113 | $217 | $292 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $361 | $394 | $426 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $376 | $548 | $625 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $189 | $251 | $318 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $337 | $401 | $482 |