| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $124 | $173 | $222 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $150 | $193 | $275 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $88 | $178 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $54 | $90 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $43 | $65 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $34 | $37 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $93 | $150 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $112 | $188 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $86 | $108 | $131 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $90 | $127 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $90 | $149 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $117 | $194 | $271 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $116 | $190 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $98 | $170 | $241 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $68 | $94 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $44 | $60 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $14 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $83 | $146 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $105 | $202 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $97 | $128 | $158 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $43 | $98 | $140 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $74 | $104 | $133 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $11 | $15 | $18 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $6 | $52 | $75 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $44 | $79 | $106 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $56 | $67 | $77 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $91 | $165 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $32 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $70 | $369 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $750 | $847 | $944 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $26 | $173 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $1,807 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $161 | $208 | $254 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $710 | $726 | $742 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $330 | $493 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $146 | $233 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $253 | $416 |
| Septoplasty CPT 30520 • ENT | $506 | $543 | $581 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $114 | $167 | $220 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $111 | $189 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $141 | $202 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $180 | $245 | $310 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $353 | $568 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $239 | $317 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $235 | $363 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $296 | $580 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $121 | $188 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $290 | $522 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $303 | $545 |