| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $41 | $102 | $219 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $51 | $128 | $280 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $62 | $165 | $348 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $34 | $68 | $144 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $72 | $100 | $174 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $56 | $103 | $231 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $67 | $93 | $165 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $62 | $134 | $226 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $118 | $200 | $338 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $131 | $188 | $303 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $112 | $156 | $252 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $115 | $182 | $347 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $117 | $238 | $402 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $186 | $289 | $432 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $98 | $191 | $358 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $80 | $125 | $245 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $43 | $79 | $144 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $10 | $33 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $93 | $159 | $294 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $50 | $109 | $201 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $65 | $137 | $235 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $1 | $70 | $210 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $1 | $119 | $207 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $18 | $41 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $6 | $11 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $53 | $105 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $68 | $123 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $77 | $407 | $1,104 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $70 | $184 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $62 | $177 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $109 | $395 | $1,005 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $944 | $6,060 | $18,881 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $26 | $196 | $586 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $221 | $1,809 | $4,426 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $161 | $308 | $735 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $549 | $837 | $1,038 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $76 | $528 | $1,205 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $146 | $304 | $673 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $317 | $424 | $520 |
| Septoplasty CPT 30520 • ENT | $537 | $862 | $1,573 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $129 | $286 | $522 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $176 | $250 | $336 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $202 | $332 | $466 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $285 | $523 | $1,019 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $330 | $440 | $554 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $207 | $262 | $399 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $307 | $401 | $586 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $439 | $602 | $834 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $170 | $293 | $443 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $286 | $450 | $648 |