| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $38 | $114 | $166 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $48 | $152 | $208 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $57 | $192 | $288 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $35 | $103 | $165 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $41 | $137 | $203 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $37 | $152 | $284 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $46 | $143 | $327 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $84 | $152 | $249 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $72 | $186 | $292 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $106 | $186 | $293 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $109 | $196 | $384 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $128 | $285 | $549 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $119 | $295 | $652 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $153 | $349 | $707 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $133 | $281 | $572 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $37 | $115 | $194 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $53 | $88 | $127 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $14 | $48 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $45 | $164 | $252 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $73 | $150 | $211 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $84 | $159 | $225 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $118 | $155 | $198 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $48 | $196 | $431 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $16 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $5 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $5 | $50 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $64 | $160 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $33 | $265 | $850 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $50 | $167 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $44 | $117 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $42 | $267 | $859 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $62 | $1,883 | $7,170 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $152 | $409 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $322 | $2,369 | $4,534 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $230 | $346 | $726 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $548 | $1,205 | $2,355 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $342 | $511 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $111 | $280 | $829 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $45 | $310 | $446 |
| Septoplasty CPT 30520 • ENT | $538 | $857 | $1,159 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $148 | $317 | $656 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $61 | $221 | $319 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $154 | $311 | $455 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $230 | $478 | $750 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $45 | $362 | $482 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $172 | $261 | $560 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $251 | $372 | $514 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $307 | $471 | $670 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $134 | $251 | $362 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $285 | $395 | $519 |