| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $31 | $60 | $102 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $59 | $106 | $199 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $71 | $108 | $159 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $45 | $74 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $74 | $102 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $50 | $76 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $74 | $98 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $122 | $212 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $56 | $135 | $257 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $79 | $155 | $284 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $75 | $133 | $236 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $184 | $326 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $205 | $377 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $245 | $405 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $196 | $336 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $49 | $83 | $110 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $64 | $95 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $7 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $125 | $199 | $276 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $24 | $68 | $118 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $114 | $221 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $101 | $197 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $66 | $105 | $195 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $19 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $6 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $5 | $61 | $96 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $53 | $92 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $45 | $297 | $876 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $19 | $53 | $121 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $42 | $97 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $120 | $265 | $549 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,210 | $5,427 | $13,615 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $35 | $79 | $181 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $402 | $1,678 | $3,711 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $212 | $358 | $689 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $624 | $969 | $1,291 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $401 | $643 | $952 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $111 | $277 | $631 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $222 | $377 | $487 |
| Septoplasty CPT 30520 • ENT | $478 | $709 | $932 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $110 | $216 | $362 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $44 | $107 | $204 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $209 | $306 | $436 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $308 | $447 | $720 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $263 | $434 | $519 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $219 | $265 | $307 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $208 | $347 | $426 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $332 | $536 | $625 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $109 | $205 | $318 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $286 | $362 | $482 |