| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $47 | $82 | $110 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $59 | $90 | $131 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $71 | $94 | $156 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $43 | $78 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $63 | $100 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $87 | $149 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $67 | $117 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $4 | $66 | $125 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $5 | $88 | $175 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $6 | $55 | $100 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $5 | $89 | $157 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $6 | $126 | $229 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $7 | $134 | $248 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $8 | $180 | $294 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $7 | $114 | $202 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $62 | $116 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $21 | $49 | $97 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $11 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $5 | $131 | $191 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $66 | $112 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $4 | $78 | $133 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $4 | $73 | $133 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $76 | $125 | $175 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $27 | $57 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $16 | $62 | $91 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $75 | $162 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $88 | $208 | $586 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $22 | $57 | $155 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $14 | $31 | $65 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $119 | $288 | $795 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $85 | $2,472 | $6,694 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $36 | $156 | $409 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $402 | $1,845 | $3,791 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $244 | $364 | $548 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $19 | $969 | $2,130 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $401 | $602 | $900 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $111 | $264 | $503 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $9 | $255 | $330 |
| Septoplasty CPT 30520 • ENT | $30 | $707 | $1,419 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $7 | $173 | $288 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $116 | $195 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $8 | $134 | $273 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $8 | $194 | $331 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $9 | $382 | $945 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $6 | $131 | $316 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $8 | $229 | $510 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $330 | $582 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $6 | $109 | $210 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $9 | $224 | $442 |