| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $31 | $113 | $214 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $55 | $146 | $268 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $67 | $97 | $127 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $108 | $213 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $131 | $258 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $78 | $148 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $99 | $169 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $41 | $137 | $267 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $183 | $325 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $180 | $247 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $52 | $156 | $299 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $209 | $286 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $276 | $481 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $299 | $514 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $225 | $428 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $49 | $108 | $157 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $96 | $170 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $7 | $10 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $125 | $218 | $359 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $228 | $542 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $152 | $275 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $127 | $262 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $66 | $159 | $362 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $22 | $26 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $6 | $7 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $47 | $66 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $7 | $26 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $143 | $499 | $843 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $20 | $50 | $95 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $35 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $120 | $283 | $500 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $85 | $2,789 | $6,565 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $36 | $55 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $371 | $796 | $1,615 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $221 | $251 | $287 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $903 | $1,061 | $1,291 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $401 | $578 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $111 | $196 | $294 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $228 | $486 | $1,016 |
| Septoplasty CPT 30520 • ENT | $324 | $783 | $1,400 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $156 | $283 | $466 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $80 | $158 | $309 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $139 | $268 | $384 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $308 | $515 | $911 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $417 | $624 | $947 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $219 | $300 | $375 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $340 | $434 | $552 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $527 | $666 | $788 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $189 | $237 | $285 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $337 | $456 | $603 |