| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $47 | $164 | $263 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $59 | $185 | $330 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $71 | $218 | $400 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $121 | $251 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $107 | $203 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $23 | $109 | $259 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $124 | $295 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $181 | $322 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $221 | $390 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $79 | $201 | $306 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $52 | $196 | $355 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $251 | $506 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $327 | $599 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $322 | $576 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $262 | $527 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $49 | $134 | $264 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $88 | $198 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $22 | $58 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $124 | $251 | $393 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $24 | $122 | $286 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $189 | $341 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $118 | $165 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $64 | $196 | $372 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $26 | $50 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $8 | $17 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $47 | $83 | $131 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $82 | $160 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $88 | $281 | $674 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $41 | $141 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $28 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $79 | $226 | $732 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $85 | $2,287 | $6,373 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $35 | $186 | $423 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $371 | $2,122 | $6,068 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $122 | $301 | $534 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $164 | $985 | $1,371 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $102 | $559 | $877 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $98 | $236 | $490 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $167 | $700 | $1,417 |
| Septoplasty CPT 30520 • ENT | $478 | $1,129 | $2,024 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $156 | $369 | $729 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $58 | $234 | $666 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $88 | $411 | $833 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $217 | $570 | $900 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $263 | $681 | $1,320 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $157 | $357 | $651 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $250 | $527 | $1,047 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $332 | $821 | $1,667 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $153 | $310 | $706 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $231 | $524 | $1,089 |