| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $49 | $121 | $191 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $144 | $187 | $231 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $24 | $78 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $41 | $55 | $69 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $37 | $53 | $66 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $59 | $114 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $60 | $114 | $158 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $78 | $143 | $190 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $125 | $155 | $172 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $105 | $118 | $132 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $142 | $191 | $240 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $30 | $162 | $286 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $122 | $190 | $238 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $150 | $154 | $159 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $50 | $86 | $131 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $42 | $59 | $71 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $11 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $140 | $163 | $185 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $49 | $100 | $134 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $97 | $122 | $133 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $46 | $48 | $51 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $56 | $145 | $234 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $11 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $4 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $10 | $45 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $12 | $33 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $96 | $394 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $22 | $100 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $44 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $133 | $532 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,202 | $5,781 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $33 | $152 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $282 | $1,417 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $211 | $266 | $322 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $904 | $940 | $977 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $458 | $652 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $191 | $278 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $291 | $339 | $432 |
| Septoplasty CPT 30520 • ENT | $475 | $646 | $799 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $30 | $170 | $301 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $154 | $199 | $259 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $156 | $235 | $314 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $238 | $437 | $637 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $352 | $413 | $474 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $173 | $197 | $266 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $278 | $373 | $468 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $443 | $595 | $746 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $111 | $193 | $280 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $242 | $338 | $434 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $254 | $353 | $452 |