| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $49 | $129 | $222 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $84 | $133 | $152 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $94 | $114 | $178 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $77 | $108 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $39 | $69 | $104 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $85 | $113 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $120 | $131 | $150 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $102 | $147 | $188 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $109 | $129 | $167 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $127 | $133 | $139 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $91 | $166 | $193 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $94 | $179 | $222 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $228 | $240 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $122 | $143 | $198 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $78 | $93 | $106 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $35 | $51 | $65 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $5 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $94 | $164 | $253 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $67 | $122 | $202 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $126 | $134 | $158 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $109 | $113 | $119 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $152 | $155 | $158 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $8 | $11 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $6 | $53 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $34 | $46 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $56 | $219 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $134 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $25 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $70 | $501 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $75 | $4,235 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $22 | $86 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $1,920 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $299 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $742 | $858 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $330 | $595 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $188 | $282 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $176 | $245 | $291 |
| Septoplasty CPT 30520 • ENT | $430 | $594 | $665 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $135 | $172 | $230 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $114 | $168 | $192 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $192 | $235 | $250 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $180 | $321 | $431 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $317 | $381 | $568 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $113 | $163 | $178 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $259 | $278 | $311 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $369 | $373 | $376 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $144 | $176 | $188 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $284 | $324 | $443 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $194 | $262 | $297 |