| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $100 | $196 | $326 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $145 | $282 | $403 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $72 | $151 | $264 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $128 | $234 | $314 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $80 | $201 | $275 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $65 | $217 | $300 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $183 | $259 | $328 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $199 | $311 | $399 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $156 | $333 | $438 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $98 | $266 | $367 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $284 | $368 | $505 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $319 | $467 | $579 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $222 | $399 | $616 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $182 | $393 | $518 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $89 | $203 | $292 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $61 | $123 | $169 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $12 | $17 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $89 | $326 | $426 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $103 | $218 | $291 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $120 | $255 | $337 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $112 | $222 | $295 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $157 | $304 | $380 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $8 | $15 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $52 | $61 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $9 | $36 | $58 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $260 | $605 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $16 | $22 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $17 | $53 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $193 | $652 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $2,101 | $7,571 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $57 | $190 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $366 | $1,668 | $2,852 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $277 | $405 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $802 | $883 | $1,117 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $356 | $536 | $880 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $182 | $233 | $367 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $382 | $708 | $1,016 |
| Septoplasty CPT 30520 • ENT | $615 | $1,383 | $1,716 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $139 | $427 | $574 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $58 | $384 | $489 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $144 | $487 | $645 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $415 | $845 | $1,117 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $691 | $797 | $947 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $257 | $391 | $440 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $482 | $610 | $648 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $339 | $814 | $925 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $197 | $404 | $491 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $440 | $658 | $712 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $459 | $687 | $744 |