| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $8 | $165 | $328 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $8 | $99 | $159 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $11 | $56 | $93 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $54 | $152 | $318 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $41 | $171 | $276 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $137 | $236 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $12 | $214 | $349 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $83 | $243 | $401 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $63 | $160 | $304 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $15 | $190 | $366 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $64 | $239 | $517 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $11 | $203 | $395 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $19 | $229 | $432 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $18 | $298 | $540 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $8 | $164 | $291 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $9 | $108 | $209 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $8 | $22 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $14 | $263 | $416 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $13 | $134 | $291 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $13 | $136 | $343 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $75 | $161 | $333 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $52 | $145 | $199 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $16 | $22 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $32 | $52 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $28 | $46 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $59 | $64 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $57 | $145 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $59 | $86 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $614 | $890 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $4,776 | $7,860 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $85 | $209 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $184 | $1,155 | $1,842 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $23 | $129 | $210 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $45 | $434 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $47 | $251 | $456 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $13 | $109 | $190 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $36 | $289 | $478 |
| Septoplasty CPT 30520 • ENT | $368 | $855 | $1,707 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $82 | $342 | $567 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $34 | $232 | $503 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $77 | $338 | $667 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $47 | $462 | $1,108 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $84 | $457 | $872 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $85 | $246 | $484 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $50 | $607 | $1,060 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $526 | $1,079 | $1,695 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $25 | $185 | $358 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $34 | $357 | $769 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $196 | $499 | $803 |