| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $63 | $142 | $222 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $182 | $215 | $275 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $77 | $124 | $178 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $90 | $98 | $105 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $42 | $54 | $65 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $65 | $96 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $88 | $129 | $150 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $117 | $162 | $188 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $86 | $134 | $181 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $114 | $136 | $166 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $91 | $176 | $230 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $171 | $221 | $271 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $250 | $283 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $142 | $191 | $241 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $66 | $85 | $94 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $41 | $61 | $78 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $16 | $36 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $73 | $136 | $200 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $123 | $152 | $202 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $98 | $128 | $158 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $76 | $108 | $140 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $74 | $137 | $200 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $11 | $16 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $6 | $41 | $64 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $44 | $71 | $91 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $56 | $384 | $702 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $122 | $165 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $53 | $81 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $70 | $136 | $168 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $750 | $4,712 | $8,582 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $29 | $190 | $232 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $213 | $218 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $190 | $222 | $254 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $742 | $758 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $330 | $371 | $412 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $172 | $196 | $221 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $314 | $403 | $492 |
| Septoplasty CPT 30520 • ENT | $506 | $606 | $706 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $114 | $133 | $152 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $114 | $164 | $214 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $192 | $282 | $373 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $180 | $256 | $333 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $489 | $528 | $568 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $240 | $278 | $317 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $311 | $349 | $387 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $279 | $448 | $618 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $144 | $180 | $216 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $347 | $435 | $522 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $361 | $453 | $545 |