| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $47 | $65 | $101 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $59 | $92 | $125 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $71 | $130 | $248 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $59 | $101 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $38 | $89 | $121 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $85 | $170 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $27 | $83 | $188 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $55 | $82 | $126 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $71 | $113 | $155 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $79 | $110 | $170 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $66 | $94 | $142 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $71 | $164 | $323 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $82 | $185 | $381 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $179 | $241 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $77 | $192 | $335 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $49 | $85 | $118 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $54 | $69 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $7 | $8 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $123 | $143 | $181 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $34 | $62 | $111 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $76 | $130 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $47 | $105 | $181 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $76 | $167 | $264 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $21 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $6 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $5 | $52 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $41 | $65 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $143 | $521 | $876 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $19 | $65 | $141 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $20 | $64 | $97 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $120 | $360 | $732 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $85 | $2,725 | $6,373 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $55 | $228 | $409 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $402 | $2,171 | $3,711 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $246 | $287 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $544 | $941 | $1,291 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $401 | $462 | $532 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $111 | $160 | $188 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $228 | $304 | $355 |
| Septoplasty CPT 30520 • ENT | $478 | $761 | $1,056 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $72 | $198 | $367 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $80 | $130 | $206 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $124 | $255 | $425 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $284 | $427 | $689 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $263 | $371 | $459 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $133 | $219 | $306 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $330 | $381 | $452 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $582 | $672 | $790 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $189 | $196 | $204 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $186 | $277 | $337 |