| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $95 | $216 | $336 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $115 | $228 | $417 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $45 | $177 | $242 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $63 | $227 | $327 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $46 | $46 | $47 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $57 | $90 | $123 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $77 | $77 | $77 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $68 | $221 | $374 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $75 | $75 | $75 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $66 | $265 | $384 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $119 | $324 | $530 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $147 | $147 | $147 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $162 | $358 | $657 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $127 | $336 | $545 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $61 | $135 | $276 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $53 | $107 | $161 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $18 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $119 | $261 | $404 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $73 | $216 | $304 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $87 | $194 | $355 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $51 | $87 | $122 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $133 | $145 | $156 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $14 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $49 | $53 | $56 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $39 | $42 | $46 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $76 | $294 | $512 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $80 | $143 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $8 | $10 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $66 | $86 | $105 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $932 | $3,749 | $6,565 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $34 | $133 | $232 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $215 | $1,057 | $2,736 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $175 | $184 | $194 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $593 | $593 | $593 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $33 | $239 | $359 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $15 | $111 | $167 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $315 | $610 | $800 |
| Septoplasty CPT 30520 • ENT | $447 | $1,139 | $1,831 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $97 | $343 | $589 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $138 | $365 | $506 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $243 | $517 | $691 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $219 | $700 | $1,182 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $323 | $658 | $872 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $158 | $342 | $433 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $255 | $402 | $638 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $408 | $778 | $1,018 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $130 | $297 | $464 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $211 | $568 | $789 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $220 | $595 | $826 |