| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $34 | $134 | $233 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $31 | $156 | $282 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $41 | $69 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $25 | $76 | $103 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $23 | $49 | $76 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $11 | $112 | $212 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $8 | $81 | $153 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $31 | $98 | $198 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $17 | $154 | $311 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $10 | $131 | $253 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $24 | $192 | $361 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $111 | $270 | $429 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $167 | $316 | $465 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $122 | $249 | $375 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $16 | $102 | $187 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $26 | $61 | $100 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $6 | $11 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $25 | $107 | $190 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $11 | $107 | $207 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $11 | $123 | $246 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $22 | $82 | $131 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $31 | $80 | $129 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $20 | $32 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $7 | $11 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $47 | $65 | $83 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $21 | $48 | $72 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $69 | $100 | $134 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $74 | $179 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $18 | $39 | $53 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $60 | $263 | $549 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $399 | $1,171 | $1,642 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $27 | $38 | $52 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,281 | $3,065 | $3,849 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $37 | $186 | $334 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $544 | $927 | $1,310 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $120 | $423 | $725 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $167 | $234 | $302 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $146 | $490 | $834 |
| Septoplasty CPT 30520 • ENT | $45 | $616 | $1,187 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $12 | $221 | $431 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $9 | $100 | $165 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $23 | $222 | $329 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $36 | $283 | $530 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $48 | $412 | $777 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $26 | $205 | $385 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $26 | $322 | $617 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $277 | $629 | $980 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $66 | $165 | $265 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $285 | $424 | $564 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $307 | $585 |