| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $46 | $117 | $189 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $56 | $140 | $234 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $34 | $78 | $150 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $51 | $118 | $182 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $21 | $72 | $158 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $45 | $70 | $97 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $77 | $116 | $188 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $90 | $141 | $229 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $113 | $180 | $253 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $98 | $108 | $119 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $125 | $152 | $168 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $150 | $218 | $314 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $163 | $249 | $363 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $129 | $142 | $169 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $34 | $82 | $171 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $57 | $72 | $96 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $11 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $100 | $139 | $163 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $66 | $101 | $165 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $76 | $91 | $110 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $107 | $110 | $116 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $47 | $83 | $145 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $9 | $11 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $4 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $6 | $75 | $158 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $83 | $193 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $65 | $439 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $16 | $276 | $753 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $54 | $117 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $70 | $168 | $348 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $62 | $1,086 | $3,122 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $98 | $213 | $319 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $2,614 | $7,319 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $230 | $373 | $636 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $481 | $688 | $840 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $330 | $519 | $799 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $194 | $249 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $166 | $233 | $291 |
| Septoplasty CPT 30520 • ENT | $639 | $777 | $1,024 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $144 | $171 | $216 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $59 | $103 | $185 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $149 | $214 | $252 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $224 | $438 | $658 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $296 | $351 | $438 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $113 | $152 | $176 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $167 | $223 | $260 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $347 | $427 | $565 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $130 | $166 | $190 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $277 | $336 | $443 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $289 | $337 | $421 |