| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $5 | $27 | $49 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $28 | $87 | $146 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $56 | $78 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $41 | $50 | $60 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $41 | $48 | $56 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $10 | $39 | $68 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $63 | $104 | $169 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $51 | $84 | $118 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $122 | $162 | $203 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $21 | $92 | $164 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $27 | $61 | $95 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $119 | $142 | $165 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $134 | $188 | $242 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $74 | $98 | $123 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $9 | $25 | $41 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $6 | $39 | $72 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $4 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $21 | $122 | $224 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $13 | $85 | $153 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $9 | $59 | $110 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $66 | $88 | $110 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $12 | $76 | $140 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $10 | $17 | $24 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $5 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $37 | $52 | $67 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $33 | $45 | $58 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $69 | $74 | $78 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $76 | $134 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $34 | $57 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $73 | $83 | $93 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $953 | $3,504 | $6,054 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $34 | $151 | $268 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $266 | $1,251 | $2,235 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $54 | $161 | $269 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $814 | $915 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $421 | $610 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $25 | $117 | $208 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $149 | $267 |
| Septoplasty CPT 30520 • ENT | $505 | $655 | $805 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $93 | $140 | $188 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $23 | $131 | $240 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $27 | $222 | $418 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $36 | $129 | $223 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $238 | $393 | $548 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $222 | $269 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $165 | $212 | $259 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $74 | $383 | $692 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $92 | $167 | $241 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $42 | $162 | $282 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $182 | $215 | $248 |