| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $40 | $126 | $181 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $33 | $139 | $182 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $86 | $164 | $222 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $36 | $100 | $180 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $62 | $129 | $174 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $47 | $109 | $189 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $84 | $142 | $210 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $118 | $169 | $228 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $144 | $188 | $219 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $112 | $196 | $242 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $81 | $176 | $256 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $137 | $208 | $282 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $93 | $251 | $324 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $121 | $304 | $440 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $82 | $191 | $289 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $40 | $120 | $163 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $72 | $86 | $96 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $12 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $113 | $190 | $238 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $80 | $119 | $159 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $110 | $149 | $186 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $74 | $100 | $167 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $148 | $196 | $227 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $11 | $19 | $22 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $5 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $3 | $38 | $76 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $11 | $42 | $58 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $76 | $205 | $545 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $51 | $145 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $29 | $85 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $104 | $314 | $889 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $932 | $5,931 | $13,615 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $94 | $278 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $218 | $1,261 | $2,486 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $155 | $250 | $491 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $447 | $943 | $1,291 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $401 | $603 | $912 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $74 | $214 | $423 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $299 | $462 | $586 |
| Septoplasty CPT 30520 • ENT | $637 | $817 | $940 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $94 | $271 | $394 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $60 | $205 | $276 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $177 | $323 | $418 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $152 | $483 | $794 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $406 | $495 | $583 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $110 | $216 | $269 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $281 | $358 | $434 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $448 | $540 | $692 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $166 | $257 | $350 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $389 | $405 | $439 |