| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $23 | $77 | $123 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $22 | $78 | $152 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $7 | $23 | $38 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $34 | $63 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $19 | $29 | $39 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $44 | $57 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $38 | $58 | $78 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $76 | $91 | $105 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $52 | $65 | $78 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $14 | $43 | $72 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $59 | $145 | $193 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $26 | $86 | $146 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $164 | $189 | $237 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $189 | $190 | $192 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $9 | $42 | $76 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $37 | $42 | $47 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $2 | $4 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $16 | $41 | $66 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $54 | $80 | $109 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $72 | $97 | $128 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $67 | $97 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $76 | $113 | $152 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $25 | $54 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $26 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $280 | $484 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $122 | $179 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $23 | $44 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $36 | $73 | $93 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $283 | $4,569 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $10 | $76 | $192 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $304 | $1,169 | $2,281 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $55 | $195 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $75 | $414 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $80 | $174 | $268 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $50 | $165 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $130 | $206 | $291 |
| Septoplasty CPT 30520 • ENT | $456 | $529 | $665 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $149 | $173 | $215 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $183 | $201 | $219 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $129 | $210 | $251 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $41 | $254 | $431 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $38 | $193 | $317 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $26 | $63 | $125 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $130 | $234 | $314 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $55 | $278 | $500 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $29 | $108 | $186 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $43 | $175 | $284 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $49 | $215 | $299 |