| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $53 | $115 | $188 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $71 | $152 | $214 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $72 | $101 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $100 | $125 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $106 | $217 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $71 | $118 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $104 | $129 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $139 | $160 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $149 | $241 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $45 | $102 | $140 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $176 | $203 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $191 | $239 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $220 | $339 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $180 | $263 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $45 | $70 | $114 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $65 | $84 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $10 | $45 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $45 | $131 | $231 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $122 | $236 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $113 | $137 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $95 | $126 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $71 | $130 | $195 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $11 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $12 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $27 | $103 | $504 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $36 | $49 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $61 | $728 | $3,568 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $93 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $6 | $28 | $62 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $64 | $394 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $722 | $4,233 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $139 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $304 | $2,573 | $8,027 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $641 | $2,589 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $815 | $872 | $989 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $452 | $1,006 | $4,248 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $182 | $204 | $223 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $152 | $348 | $456 |
| Septoplasty CPT 30520 • ENT | $478 | $723 | $1,271 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $141 | $202 | $241 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $80 | $165 | $208 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $170 | $257 | $340 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $260 | $286 | $336 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $346 | $400 | $459 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $192 | $225 | $367 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $284 | $353 | $550 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $405 | $483 | $582 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $143 | $179 | $206 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $307 | $364 | $615 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $318 | $379 | $640 |