| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $108 | $168 | $288 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $131 | $193 | $357 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $53 | $192 | $242 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $72 | $179 | $292 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $54 | $194 | $284 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $65 | $215 | $313 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $90 | $169 | $225 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $110 | $287 | $419 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $122 | $276 | $395 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $99 | $264 | $343 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $137 | $243 | $454 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $169 | $364 | $526 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $186 | $280 | $563 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $147 | $386 | $545 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $76 | $155 | $276 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $61 | $116 | $161 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $21 | $33 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $135 | $305 | $452 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $86 | $176 | $271 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $101 | $123 | $189 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $75 | $109 | $177 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $185 | $203 | $239 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $15 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $5 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $28 | $39 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $38 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $38 | $388 | $643 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $100 | $145 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $58 | $85 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $50 | $535 | $889 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $440 | $5,387 | $7,860 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $15 | $167 | $278 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,104 | $1,542 | $1,843 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $155 | $157 | $160 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $419 | $433 | $447 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $310 | $323 | $348 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $125 | $130 | $145 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $355 | $528 | $715 |
| Septoplasty CPT 30520 • ENT | $491 | $850 | $1,569 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $184 | $367 | $505 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $158 | $300 | $452 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $272 | $438 | $617 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $232 | $342 | $562 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $417 | $590 | $778 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $169 | $363 | $433 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $329 | $527 | $638 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $526 | $831 | $1,018 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $25 | $252 | $446 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $268 | $479 | $705 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $280 | $638 | $826 |