| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $63 | $88 | $137 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $68 | $97 | $166 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $84 | $108 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $38 | $60 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $35 | $45 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $57 | $126 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $66 | $138 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $76 | $168 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $30 | $79 | $129 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $71 | $153 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $76 | $216 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $30 | $142 | $254 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $91 | $276 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $30 | $127 | $224 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $82 | $121 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $40 | $60 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $22 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $67 | $112 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $92 | $122 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $71 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $112 | $115 | $125 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $76 | $127 | $152 |
| 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 | $52 | $68 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $47 | $51 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $61 | $480 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $123 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $42 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $81 | $657 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $722 | $779 | $807 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $148 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $268 | $2,348 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $315 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $815 | $915 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $452 | $683 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $188 | $297 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $73 | $202 |
| Septoplasty CPT 30520 • ENT | $30 | $255 | $706 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $155 | $185 | $215 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $78 | $221 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $93 | $284 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $30 | $112 | $277 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $115 | $369 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $183 | $205 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $98 | $302 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $215 | $431 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $91 | $212 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $104 | $326 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $133 | $339 |