| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $16 | $65 | $107 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $10 | $77 | $130 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $6 | $121 | $274 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $15 | $62 | $102 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $42 | $48 | $61 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $31 | $130 | $317 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $16 | $45 | $77 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $42 | $130 | $285 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $15 | $175 | $468 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $42 | $171 | $382 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $42 | $180 | $334 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $13 | $228 | $629 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $43 | $310 | $675 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $17 | $249 | $558 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $20 | $121 | $299 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $23 | $81 | $177 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $14 | $42 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $42 | $75 | $98 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $6 | $135 | $306 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $84 | $140 | $223 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $32 | $141 | $328 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $43 | $209 | $447 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $11 | $47 | $66 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $7 | $39 | $62 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $75 | $443 | $753 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $138 | $156 | $184 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $42 | $86 | $108 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $106 | $706 | $1,005 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $903 | $3,620 | $9,052 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $30 | $144 | $228 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $316 | $957 | $2,238 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $20 | $166 | $280 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $275 | $469 | $663 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $199 | $385 | $559 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $24 | $137 | $226 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $70 | $344 | $496 |
| Septoplasty CPT 30520 • ENT | $329 | $925 | $1,789 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $42 | $254 | $599 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $22 | $258 | $530 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $137 | $283 | $440 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $217 | $296 | $382 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $63 | $463 | $903 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $105 | $272 | $502 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $42 | $282 | $737 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $42 | $391 | $1,051 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $42 | $179 | $376 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $337 | $492 | $800 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $42 | $307 | $836 |