| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $31 | $59 | $100 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $39 | $74 | $124 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $71 | $99 | $154 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $55 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $68 | $120 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $23 | $52 | $105 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $82 | $114 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $41 | $74 | $125 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $99 | $154 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $64 | $105 | $170 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $75 | $113 | $141 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $137 | $195 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $143 | $226 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $177 | $241 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $143 | $200 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $49 | $85 | $149 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $54 | $87 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $7 | $15 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $125 | $164 | $200 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $91 | $146 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $32 | $69 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $79 | $104 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $66 | $95 | $144 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $20 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $6 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $5 | $51 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $45 | $65 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $88 | $272 | $586 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $19 | $74 | $167 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $33 | $70 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $120 | $402 | $859 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,716 | $7,501 | $13,615 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $35 | $116 | $257 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $402 | $2,314 | $3,711 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $211 | $247 | $287 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $488 | $923 | $1,291 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $401 | $503 | $576 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $111 | $185 | $262 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $222 | $289 | $330 |
| Septoplasty CPT 30520 • ENT | $315 | $511 | $741 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $70 | $154 | $237 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $80 | $177 | $248 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $209 | $235 | $278 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $179 | $322 | $479 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $330 | $402 | $459 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $197 | $207 | $219 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $208 | $287 | $361 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $417 | $509 | $582 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $189 | $217 | $259 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $311 | $359 | $429 |