| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $62 | $90 | $119 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $14 | $37 | $60 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $35 | $58 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $7 | $74 | $114 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $4 | $22 | $39 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $11 | $66 | $108 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $7 | $63 | $118 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $31 | $80 | $142 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $15 | $82 | $158 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $129 | $134 | $140 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $145 | $164 | $184 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $151 | $185 | $219 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $131 | $160 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $139 | $165 | $192 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $13 | $68 | $96 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $13 | $45 | $64 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $4 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $82 | $99 | $117 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $95 | $103 | $110 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $83 | $102 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $67 | $90 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $35 | $92 | $149 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $14 | $19 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $4 | $5 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $50 | $61 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $42 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $60 | $65 | $69 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $54 | $134 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $44 | $86 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $78 | $284 | $695 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $704 | $2,923 | $5,142 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $113 | $203 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $262 | $822 | $1,382 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $36 | $118 | $200 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $508 | $645 | $783 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $434 | $617 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $33 | $166 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $204 | $315 | $426 |
| Septoplasty CPT 30520 • ENT | $98 | $352 | $606 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $75 | $104 | $132 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $64 | $136 | $210 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $125 | $235 | $329 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $119 | $194 | $270 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $313 | $355 | $396 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $132 | $164 | $196 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $34 | $174 | $314 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $500 | $513 | $526 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $108 | $186 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $214 | $251 | $288 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $31 | $165 | $299 |