| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $46 | $182 | $401 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $56 | $189 | $496 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $118 | $323 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $103 | $165 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $125 | $338 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $142 | $372 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $149 | $268 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $233 | $499 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $258 | $549 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $75 | $208 | $458 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $248 | $390 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $261 | $474 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $324 | $515 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $307 | $649 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $41 | $121 | $189 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $105 | $214 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $14 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $100 | $289 | $539 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $166 | $362 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $165 | $263 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $154 | $369 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $47 | $148 | $262 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $13 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $4 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $61 | $72 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $54 | $78 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $94 | $375 | $850 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $23 | $203 | $753 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $47 | $119 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $126 | $894 | $3,056 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,099 | $5,613 | $11,591 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $37 | $144 | $319 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $402 | $2,540 | $4,534 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $230 | $320 | $401 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $840 | $969 | $1,047 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $427 | $640 | $869 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $182 | $271 | $362 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $166 | $617 | $1,016 |
| Septoplasty CPT 30520 • ENT | $478 | $1,156 | $2,453 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $144 | $383 | $789 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $59 | $240 | $678 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $149 | $402 | $925 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $224 | $610 | $1,584 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $296 | $712 | $1,168 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $167 | $337 | $650 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $244 | $515 | $958 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $347 | $720 | $1,364 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $130 | $275 | $485 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $277 | $530 | $1,043 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $289 | $554 | $1,092 |