| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $41 | $105 | $149 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $125 | $153 | $181 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $61 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $62 | $100 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $62 | $87 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $69 | $95 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $84 | $124 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $103 | $152 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $118 | $142 | $167 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $63 | $106 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $99 | $162 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $137 | $163 | $189 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $148 | $211 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $105 | $140 | $176 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $68 | $91 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $52 | $69 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $16 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $103 | $198 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $81 | $109 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $77 | $110 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $39 | $82 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $70 | $102 | $134 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $13 | $53 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $38 | $48 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $269 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $123 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $59 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $502 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $5,572 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $190 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,438 | $2,640 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $210 | $210 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $823 | $823 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $456 | $628 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $190 | $262 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $246 | $426 |
| Septoplasty CPT 30520 • ENT | $536 | $585 | $665 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $178 | $202 | $226 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $115 | $195 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $175 | $362 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $205 | $275 | $344 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $271 | $510 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $152 | $188 | $248 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $172 | $402 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $331 | $644 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $110 | $189 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $199 | $325 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $211 | $352 |