| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $4 | $96 | $184 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $24 | $123 | $223 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $3 | $75 | $147 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $70 | $80 | $93 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $4 | $30 | $57 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $32 | $44 | $68 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $10 | $97 | $184 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $32 | $72 | $151 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $26 | $137 | $248 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $33 | $105 | $205 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $112 | $183 | $289 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $22 | $179 | $335 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $38 | $196 | $361 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $78 | $187 | $297 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $76 | $105 | $161 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $36 | $65 | $95 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $4 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $38 | $134 | $231 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $5 | $63 | $98 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $15 | $103 | $192 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $75 | $115 | $196 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $16 | $149 | $273 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $24 | $54 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $10 | $37 | $63 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $447 | $739 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $102 | $167 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $59 | $98 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $386 | $995 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $6,196 | $9,032 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $18 | $196 | $325 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $208 | $969 | $2,381 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $243 | $255 | $278 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $60 | $374 | $687 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $195 | $344 | $446 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $32 | $126 | $184 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $266 | $336 | $385 |
| Septoplasty CPT 30520 • ENT | $49 | $473 | $879 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $22 | $160 | $298 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $26 | $154 | $264 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $12 | $187 | $344 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $104 | $295 | $573 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $258 | $438 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $76 | $157 | $244 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $36 | $197 | $358 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $192 | $362 | $511 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $14 | $111 | $207 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $29 | $253 | $442 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $45 | $253 | $462 |