| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $39 | $58 | $88 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $49 | $88 | $138 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $59 | $96 | $135 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $59 | $96 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $72 | $106 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $69 | $102 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $60 | $101 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $109 | $162 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $137 | $201 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $79 | $139 | $220 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $52 | $119 | $208 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $151 | $229 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $215 | $285 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $213 | $302 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $169 | $239 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $49 | $94 | $112 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $60 | $106 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $4 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $96 | $147 | $185 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $93 | $134 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $104 | $161 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $118 | $237 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $66 | $90 | $149 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $17 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $5 | $46 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $40 | $65 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $319 | $843 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $44 | $130 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $37 | $97 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $237 | $680 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $5,443 | $13,615 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $140 | $409 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $216 | $796 | $2,196 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $206 | $247 | $287 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $467 | $878 | $1,291 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $383 | $437 | $532 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $111 | $174 | $210 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $222 | $287 | $330 |
| Septoplasty CPT 30520 • ENT | $478 | $757 | $1,277 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $110 | $196 | $290 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $44 | $121 | $186 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $139 | $210 | $293 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $241 | $367 | $438 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $310 | $438 | $580 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $171 | $240 | $327 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $254 | $323 | $477 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $362 | $531 | $678 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $132 | $190 | $258 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $270 | $374 | $547 |