| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $113 | $121 | $136 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $136 | $204 | $400 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $38 | $54 | $95 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $41 | $110 | $311 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $41 | $63 | $108 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $41 | $63 | $129 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $41 | $127 | $322 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $38 | $140 | $390 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $41 | $237 | $434 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $41 | $137 | $276 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $41 | $157 | $506 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $195 | $297 | $400 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $41 | $193 | $650 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $40 | $247 | $364 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $38 | $96 | $264 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $38 | $79 | $198 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $18 | $41 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $41 | $117 | $268 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $41 | $102 | $286 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $41 | $88 | $227 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $73 | $98 | $165 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $166 | $182 | $189 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $22 | $50 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $7 | $17 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $24 | $54 | $131 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $53 | $74 | $115 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $69 | $324 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $27 | $128 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $16 | $61 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $160 | $677 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $2,589 | $6,244 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $81 | $194 | $246 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,280 | $3,608 | $6,068 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $266 | $276 | $296 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $838 | $946 | $1,162 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $436 | $505 | $643 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $215 | $228 | $268 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $41 | $385 | $1,417 |
| Septoplasty CPT 30520 • ENT | $601 | $1,075 | $2,024 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $225 | $477 | $729 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $41 | $197 | $666 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $41 | $379 | $833 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $41 | $327 | $900 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $41 | $536 | $1,320 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $193 | $308 | $651 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $41 | $427 | $1,047 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $41 | $560 | $1,667 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $41 | $228 | $510 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $41 | $415 | $1,089 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $41 | $372 | $1,131 |