| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $59 | $131 | $246 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $71 | $208 | $297 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $104 | $195 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $49 | $79 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $40 | $62 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $77 | $114 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $159 | $247 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $193 | $302 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $218 | $336 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $103 | $203 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $115 | $245 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $208 | $282 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $85 | $130 | $205 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $30 | $88 | $157 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $49 | $91 | $140 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $61 | $85 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $7 | $36 | $85 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $125 | $252 | $321 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $86 | $140 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $80 | $109 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $71 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $76 | $108 | $152 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $21 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $6 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $78 | $118 | $158 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $106 | $193 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $143 | $416 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $36 | $47 | $58 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $20 | $27 | $34 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $229 | $288 | $348 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,716 | $2,419 | $3,122 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $55 | $76 | $98 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $402 | $3,861 | $7,319 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $287 | $325 | $363 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $989 | $1,002 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $532 | $666 | $799 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $182 | $258 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $330 | $500 | $603 |
| Septoplasty CPT 30520 • ENT | $478 | $852 | $1,298 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $30 | $169 | $319 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $80 | $147 | $276 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $217 | $412 | $512 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $30 | $275 | $487 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $459 | $618 | $722 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $219 | $315 | $373 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $361 | $493 | $569 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $582 | $760 | $912 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $162 | $267 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $337 | $462 | $590 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $353 | $489 | $616 |