| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $39 | $177 | $224 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $47 | $219 | $277 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $21 | $97 | $181 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $36 | $126 | $216 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $47 | $93 | $189 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $78 | $206 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $51 | $137 | $225 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $41 | $142 | $275 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $106 | $167 | $303 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $86 | $154 | $253 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $91 | $225 | $348 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $99 | $244 | $402 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $162 | $298 | $428 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $127 | $208 | $358 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $41 | $85 | $202 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $35 | $64 | $117 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $14 | $41 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $119 | $190 | $295 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $73 | $156 | $202 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $41 | $150 | $233 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $51 | $97 | $121 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $133 | $145 | $156 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $11 | $17 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $6 | $40 | $67 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $26 | $46 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $56 | $66 | $76 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $91 | $165 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $21 | $43 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $70 | $242 | $549 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $99 | $516 | $932 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $22 | $79 | $182 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $1,482 | $2,185 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $194 | $224 | $254 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $593 | $668 | $742 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $330 | $385 | $411 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $167 | $190 | $221 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $178 | $391 | $523 |
| Septoplasty CPT 30520 • ENT | $447 | $1,088 | $1,514 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $97 | $244 | $391 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $114 | $221 | $334 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $144 | $300 | $449 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $219 | $686 | $973 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $323 | $475 | $568 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $38 | $162 | $310 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $255 | $356 | $458 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $369 | $502 | $652 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $38 | $177 | $339 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $211 | $356 | $507 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $41 | $312 | $529 |