| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $88 | $111 | $128 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $109 | $140 | $155 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $45 | $77 | $98 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $53 | $155 | $362 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $39 | $67 | $103 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $81 | $161 | $343 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $89 | $130 | $162 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $101 | $169 | $317 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $100 | $129 | $167 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $100 | $118 | $138 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $138 | $184 | $222 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $159 | $224 | $276 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $144 | $215 | $287 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $141 | $220 | $349 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $42 | $80 | $133 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $46 | $86 | $170 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $11 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $98 | $135 | $165 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $55 | $94 | $162 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $92 | $121 | $154 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $67 | $90 | $111 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $84 | $124 | $156 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $18 | $41 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $6 | $11 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $40 | $51 | $64 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $43 | $60 | $104 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $60 | $331 | $585 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $49 | $136 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $36 | $66 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $78 | $542 | $1,154 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $704 | $3,871 | $6,841 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $133 | $243 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $262 | $1,747 | $2,577 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $200 | $239 | $263 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $631 | $752 | $842 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $434 | $492 | $570 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $181 | $212 | $237 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $145 | $348 | $603 |
| Septoplasty CPT 30520 • ENT | $473 | $928 | $2,035 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $155 | $236 | $300 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $132 | $290 | $676 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $178 | $386 | $703 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $270 | $375 | $529 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $221 | $574 | $1,328 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $122 | $296 | $645 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $181 | $422 | $1,035 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $258 | $518 | $1,097 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $134 | $224 | $420 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $200 | $304 | $402 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $209 | $374 | $663 |