| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $56 | $117 | $165 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $46 | $136 | $205 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $73 | $123 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $99 | $161 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $42 | $54 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $64 | $94 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $79 | $104 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $122 | $207 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $133 | $228 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $55 | $65 | $75 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $86 | $102 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $195 | $304 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $115 | $131 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $163 | $249 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $43 | $82 | $153 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $48 | $74 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $14 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $120 | $201 | $359 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $80 | $151 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $97 | $176 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $71 | $96 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $51 | $64 | $76 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $18 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $55 | $70 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $24 | $50 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $56 | $248 | $545 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $16 | $59 | $126 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $30 | $60 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $229 | $560 | $732 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $750 | $2,946 | $6,373 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $22 | $116 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $402 | $1,841 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $254 | $270 | $287 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $742 | $866 | $989 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $330 | $516 | $686 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $182 | $197 | $221 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $144 | $497 | $1,016 |
| Septoplasty CPT 30520 • ENT | $478 | $736 | $900 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $156 | $172 | $187 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $80 | $141 | $247 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $82 | $213 | $341 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $224 | $266 | $308 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $261 | $556 | $947 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $218 | $225 | $239 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $215 | $309 | $361 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $458 | $514 | $582 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $167 | $178 | $189 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $240 | $323 | $392 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $353 | $379 | $409 |