| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $112 | $142 | $173 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $137 | $204 | $322 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $55 | $89 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $69 | $107 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $67 | $93 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $65 | $102 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $86 | $117 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $127 | $216 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $101 | $125 | $149 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $83 | $124 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $125 | $173 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $129 | $164 | $199 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $250 | $508 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $176 | $177 | $178 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $67 | $97 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $48 | $58 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $9 | $23 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $134 | $231 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $74 | $97 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $114 | $119 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $110 | $116 | $126 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $67 | $108 | $150 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $38 | $72 | $104 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $32 | $119 | $207 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $414 | $1,991 | $3,568 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $107 | $568 | $1,028 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $45 | $155 | $343 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $555 | $1,659 | $3,495 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $4,840 | $21,714 | $38,588 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $163 | $594 | $1,348 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,823 | $5,189 | $10,702 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $199 | $372 | $544 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $568 | $1,716 | $2,864 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $433 | $1,473 | $3,186 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $180 | $695 | $1,573 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $201 | $326 |
| Septoplasty CPT 30520 • ENT | $593 | $667 | $741 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $250 | $284 | $317 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $127 | $217 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $282 | $535 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $381 | $432 | $483 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $359 | $696 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $157 | $176 | $195 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $221 | $348 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $256 | $409 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $170 | $285 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $242 | $409 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $282 | $516 |