| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $113 | $166 | $219 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $271 | $326 | $381 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $47 | $82 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $213 | $255 | $298 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $144 | $258 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $44 | $77 | $110 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $173 | $316 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $384 | $384 | $384 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $167 | $295 | $423 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $264 | $264 | $264 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $344 | $415 | $485 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $562 | $562 | $562 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $353 | $601 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $311 | $311 | $311 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $130 | $166 | $201 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $98 | $166 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $9 | $16 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $221 | $411 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $197 | $239 | $280 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $196 | $327 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $112 | $115 | $119 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $152 | $154 | $155 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $6 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $27 | $58 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $21 | $37 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $280 | $485 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $61 | $120 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $18 | $47 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $36 | $64 | $92 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $283 | $4,177 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $73 | $137 | $202 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $827 | $2,049 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $163 | $266 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $154 | $584 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $268 | $534 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $132 | $266 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $282 | $520 |
| Septoplasty CPT 30520 • ENT | $680 | $935 | $1,190 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $215 | $217 | $219 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $187 | $258 | $329 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $159 | $304 | $449 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $437 | $603 | $768 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $321 | $444 | $567 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $30 | $80 | $179 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $264 | $264 | $264 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $369 | $372 | $375 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $137 | $194 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $295 | $404 | $513 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $308 | $422 | $537 |