| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $131 | $156 | $171 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $58 | $157 | $207 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $117 | $223 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $130 | $191 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $122 | $233 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $121 | $260 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $155 | $284 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $128 | $207 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $142 | $228 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $75 | $177 | $314 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $183 | $286 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $181 | $304 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $348 | $568 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $285 | $479 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $49 | $86 | $153 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $46 | $74 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $7 | $15 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $125 | $208 | $347 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $99 | $151 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $101 | $176 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $102 | $186 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $76 | $120 | $185 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $14 | $23 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $6 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $5 | $40 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $6 | $26 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $143 | $356 | $533 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $36 | $133 | $219 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $14 | $40 | $85 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $229 | $691 | $955 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $995 | $3,524 | $7,860 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $55 | $209 | $294 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $402 | $1,668 | $2,759 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $155 | $228 | $287 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $447 | $714 | $989 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $438 | $472 | $532 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $182 | $226 | $294 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $175 | $490 | $967 |
| Septoplasty CPT 30520 • ENT | $478 | $814 | $1,065 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $156 | $275 | $508 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $80 | $143 | $247 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $170 | $243 | $341 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $238 | $320 | $415 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $459 | $615 | $883 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $187 | $215 | $239 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $352 | $444 | $619 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $501 | $655 | $881 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $128 | $200 | $285 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $194 | $308 | $392 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $353 | $415 | $483 |