| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $41 | $99 | $157 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $25 | $271 | $518 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $6 | $60 | $114 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $45 | $226 | $407 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $101 | $114 | $127 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $6 | $197 | $389 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $84 | $182 | $280 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $95 | $308 | $521 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $250 | $411 | $573 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $44 | $261 | $478 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $109 | $384 | $659 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $212 | $353 | $495 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $144 | $341 | $538 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $44 | $361 | $677 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $20 | $202 | $384 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $6 | $115 | $224 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $11 | $22 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $110 | $220 | $331 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $204 | $377 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $44 | $159 | $274 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $25 | $205 | $386 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $33 | $276 | $520 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $8 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $18 | $33 | $49 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $8 | $10 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $94 | $288 | $481 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $18 | $24 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $8 | $10 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $126 | $304 | $481 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $535 | $817 | $1,099 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $37 | $114 | $192 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $211 | $1,486 | $2,761 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $22 | $211 | $401 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $498 | $772 | $1,047 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $800 | $834 | $869 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $35 | $199 | $362 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $236 | $454 | $673 |
| Septoplasty CPT 30520 • ENT | $115 | $1,338 | $2,560 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $177 | $500 | $824 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $44 | $144 | $244 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $43 | $323 | $602 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $250 | $583 | $916 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $44 | $631 | $1,219 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $29 | $354 | $679 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $143 | $571 | $1,000 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $81 | $752 | $1,423 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $151 | $434 | $717 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $314 | $701 | $1,089 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $66 | $603 | $1,140 |