| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $30 | $112 | $173 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $71 | $139 | $243 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $45 | $75 | $152 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $72 | $95 | $164 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $43 | $69 | $114 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $29 | $68 | $113 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $50 | $114 | $135 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $94 | $142 | $220 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $105 | $144 | $183 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $86 | $130 | $150 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $75 | $137 | $194 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $92 | $172 | $244 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $193 | $287 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $125 | $188 | $349 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $34 | $85 | $119 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $33 | $65 | $79 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $12 | $50 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $97 | $159 | $206 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $41 | $104 | $236 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $81 | $119 | $162 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $50 | $89 | $124 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $41 | $95 | $156 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $19 | $62 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $12 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $14 | $55 | $115 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $36 | $123 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $308 | $1,104 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $181 | $1,028 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $42 | $177 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $861 | $4,660 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $5,881 | $18,881 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $137 | $586 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $410 | $1,576 | $4,426 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $605 | $2,589 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $905 | $1,314 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $318 | $482 | $699 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $169 | $391 | $1,573 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $175 | $361 | $646 |
| Septoplasty CPT 30520 • ENT | $399 | $756 | $1,411 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $89 | $182 | $291 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $39 | $190 | $295 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $156 | $315 | $430 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $260 | $448 | $891 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $202 | $495 | $975 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $112 | $207 | $373 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $165 | $347 | $489 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $235 | $581 | $840 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $84 | $166 | $206 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $179 | $326 | $472 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $187 | $368 | $486 |