| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $59 | $101 | $131 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $58 | $98 | $132 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $72 | $105 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $107 | $191 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $74 | $104 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $73 | $96 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $97 | $127 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $105 | $127 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $118 | $142 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $75 | $110 | $142 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $145 | $192 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $155 | $196 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $222 | $378 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $222 | $479 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $49 | $67 | $83 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $43 | $57 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $6 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $124 | $133 | $154 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $82 | $113 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $86 | $112 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $88 | $186 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $76 | $109 | $136 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $15 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $5 | $52 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $6 | $33 | $62 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $143 | $526 | $753 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $32 | $118 | $219 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $14 | $44 | $107 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $198 | $597 | $1,005 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $995 | $3,370 | $9,052 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $55 | $269 | $423 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $402 | $2,651 | $4,275 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $122 | $212 | $287 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $164 | $602 | $989 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $102 | $367 | $532 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $98 | $214 | $294 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $175 | $298 | $381 |
| Septoplasty CPT 30520 • ENT | $478 | $673 | $1,065 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $156 | $185 | $242 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $80 | $143 | $222 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $170 | $223 | $273 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $217 | $263 | $308 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $317 | $431 | $502 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $157 | $193 | $219 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $251 | $392 | $619 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $389 | $596 | $881 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $128 | $173 | $221 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $194 | $275 | $337 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $241 | $357 | $483 |