| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $38 | $126 | $166 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $48 | $144 | $208 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $57 | $214 | $288 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $35 | $114 | $165 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $41 | $132 | $203 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $37 | $167 | $284 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $46 | $162 | $327 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $85 | $176 | $249 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $106 | $227 | $292 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $116 | $215 | $293 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $109 | $207 | $384 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $128 | $301 | $549 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $119 | $322 | $652 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $168 | $414 | $707 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $133 | $295 | $572 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $42 | $145 | $194 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $58 | $101 | $127 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $15 | $48 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $45 | $155 | $252 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $73 | $163 | $211 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $88 | $163 | $225 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $119 | $163 | $198 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $48 | $202 | $431 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $9 | $19 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $4 | $6 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $5 | $53 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $73 | $160 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $88 | $324 | $850 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $19 | $61 | $167 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $54 | $117 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $85 | $323 | $859 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $62 | $2,258 | $7,170 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $25 | $186 | $409 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $402 | $2,869 | $4,534 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $230 | $372 | $726 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $840 | $1,369 | $2,355 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $401 | $540 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $111 | $329 | $829 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $45 | $267 | $446 |
| Septoplasty CPT 30520 • ENT | $538 | $878 | $1,159 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $149 | $350 | $656 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $61 | $207 | $319 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $154 | $340 | $455 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $230 | $523 | $750 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $45 | $345 | $482 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $172 | $300 | $560 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $251 | $404 | $514 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $307 | $491 | $670 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $134 | $281 | $362 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $285 | $411 | $519 |