| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $47 | $137 | $263 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $59 | $128 | $190 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $71 | $172 | $400 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $100 | $251 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $75 | $145 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $23 | $74 | $160 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $119 | $295 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $155 | $322 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $191 | $390 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $79 | $180 | $306 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $52 | $164 | $355 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $208 | $353 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $282 | $599 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $285 | $439 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $249 | $527 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $49 | $111 | $264 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $66 | $141 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $19 | $58 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $124 | $225 | $393 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $24 | $97 | $286 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $162 | $341 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $110 | $165 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $64 | $166 | $372 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $22 | $50 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $7 | $17 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $47 | $80 | $131 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $71 | $160 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $88 | $293 | $674 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $19 | $47 | $141 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $28 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $120 | $261 | $732 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $85 | $2,236 | $6,373 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $35 | $204 | $423 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $371 | $1,464 | $4,275 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $122 | $302 | $534 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $164 | $955 | $1,371 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $102 | $540 | $877 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $98 | $223 | $490 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $308 | $663 | $1,417 |
| Septoplasty CPT 30520 • ENT | $478 | $1,038 | $2,024 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $156 | $309 | $729 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $58 | $217 | $666 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $88 | $351 | $833 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $217 | $515 | $900 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $263 | $618 | $1,320 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $157 | $290 | $651 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $251 | $483 | $1,047 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $332 | $672 | $1,667 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $153 | $308 | $706 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $231 | $461 | $1,089 |