| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $49 | $143 | $270 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $143 | $230 | $336 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $20 | $94 | $215 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $72 | $99 | $137 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $69 | $89 | $113 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $29 | $54 | $84 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $76 | $153 | $281 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $145 | $202 | $341 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $112 | $208 | $376 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $85 | $171 | $311 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $72 | $153 | $190 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $218 | $316 | $499 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $163 | $229 | $279 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $171 | $188 | $196 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $54 | $126 | $247 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $48 | $66 | $84 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $17 | $48 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $132 | $189 | $238 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $70 | $134 | $248 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $85 | $113 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $132 | $299 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $136 | $157 | $175 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $19 | $38 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $6 | $30 | $63 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $36 | $62 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $56 | $257 | $753 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $16 | $63 | $184 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $36 | $107 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $106 | $509 | $1,005 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $75 | $2,956 | $9,052 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $22 | $103 | $304 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $409 | $1,973 | $3,168 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $194 | $234 | $291 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $549 | $768 | $1,004 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $330 | $422 | $541 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $160 | $202 | $251 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $270 | $441 | $586 |
| Septoplasty CPT 30520 • ENT | $603 | $849 | $1,477 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $90 | $239 | $479 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $176 | $250 | $418 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $162 | $367 | $583 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $278 | $513 | $959 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $325 | $467 | $583 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $168 | $259 | $396 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $247 | $396 | $575 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $515 | $668 | $887 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $81 | $213 | $424 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $297 | $428 | $647 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $309 | $459 | $675 |