| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $49 | $99 | $123 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $15 | $76 | $152 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $20 | $28 | $35 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $60 | $98 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $37 | $58 | $99 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $9 | $56 | $113 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $8 | $44 | $79 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $88 | $146 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $25 | $100 | $162 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $101 | $103 | $105 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $137 | $193 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $22 | $155 | $222 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $31 | $169 | $240 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $18 | $112 | $195 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $79 | $92 | $106 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $49 | $56 | $63 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $5 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $14 | $85 | $146 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $22 | $51 | $67 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $12 | $89 | $128 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $22 | $81 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $6 | $75 | $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 | $60 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $36 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $61 | $274 | $691 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $70 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $47 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $81 | $568 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $722 | $4,949 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $107 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $304 | $1,711 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $184 | $253 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $102 | $458 | $815 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $160 | $306 | $452 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $67 | $196 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $146 | $204 | $291 |
| Septoplasty CPT 30520 • ENT | $133 | $471 | $665 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $150 | $171 | $214 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $31 | $93 | $183 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $157 | $219 | $250 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $48 | $293 | $431 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $238 | $292 | $320 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $18 | $75 | $178 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $52 | $157 | $263 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $37 | $260 | $375 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $99 | $142 | $184 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $28 | $199 | $284 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $149 | $247 | $297 |