| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $38 | $102 | $151 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $47 | $100 | $190 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $56 | $135 | $187 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $78 | $160 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $74 | $149 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $71 | $160 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $87 | $175 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $112 | $206 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $156 | $248 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $174 | $277 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $52 | $132 | $223 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $189 | $286 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $230 | $349 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $228 | $412 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $172 | $308 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $47 | $87 | $175 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $66 | $109 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $7 | $13 | $37 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $125 | $166 | $194 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $90 | $182 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $105 | $217 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $99 | $179 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $51 | $116 | $200 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $21 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $6 | $8 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $5 | $44 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $7 | $26 | $63 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $73 | $285 | $843 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $20 | $55 | $145 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $53 | $97 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $109 | $337 | $889 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $85 | $2,737 | $7,860 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $34 | $45 | $59 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $362 | $410 | $507 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $211 | $278 | $370 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $840 | $1,123 | $1,371 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $401 | $503 | $607 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $111 | $175 | $216 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $304 | $531 | $1,016 |
| Septoplasty CPT 30520 • ENT | $478 | $747 | $1,025 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $156 | $231 | $339 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $49 | $151 | $340 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $139 | $275 | $434 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $308 | $450 | $683 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $322 | $406 | $459 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $181 | $249 | $312 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $208 | $324 | $461 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $376 | $575 | $790 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $166 | $212 | $313 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $300 | $383 | $492 |