| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $37 | $97 | $151 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $47 | $114 | $190 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $56 | $126 | $187 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $85 | $160 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $78 | $149 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $72 | $160 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $82 | $175 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $118 | $206 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $157 | $248 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $176 | $277 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $52 | $137 | $223 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $190 | $286 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $229 | $349 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $230 | $412 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $164 | $308 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $47 | $84 | $175 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $75 | $109 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $7 | $14 | $37 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $125 | $175 | $221 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $93 | $182 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $108 | $217 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $92 | $179 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $51 | $123 | $200 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $22 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $6 | $8 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $5 | $46 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $7 | $32 | $63 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $73 | $249 | $843 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $20 | $49 | $145 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $45 | $97 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $109 | $299 | $889 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $85 | $2,447 | $7,860 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $34 | $43 | $59 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $362 | $921 | $2,961 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $211 | $265 | $370 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $840 | $1,092 | $1,371 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $401 | $494 | $607 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $111 | $178 | $216 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $291 | $991 | $5,569 |
| Septoplasty CPT 30520 • ENT | $478 | $2,974 | $21,075 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $150 | $217 | $339 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $49 | $169 | $340 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $139 | $293 | $514 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $238 | $389 | $683 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $317 | $395 | $573 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $264 | $339 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $208 | $2,156 | $18,128 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $370 | $579 | $875 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $166 | $212 | $313 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $285 | $1,906 | $15,745 |