| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $107 | $121 | $135 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $130 | $277 | $425 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $280 | $302 | $313 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $102 | $123 | $144 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $42 | $168 | $294 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $42 | $183 | $324 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $42 | $135 | $228 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $42 | $235 | $428 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $42 | $181 | $320 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $390 | $414 | $437 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $164 | $251 | $338 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $641 | $679 | $717 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $212 | $477 | $771 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $42 | $305 | $568 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $42 | $96 | $149 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $42 | $111 | $181 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $17 | $29 | $42 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $42 | $240 | $438 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $94 | $203 | $313 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $112 | $295 | $409 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $64 | $293 | $522 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $136 | $209 | $281 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $8 | $11 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $5 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $47 | $77 | $121 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $62 | $74 | $86 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $107 | $430 | $753 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $26 | $105 | $184 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $11 | $12 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $138 | $571 | $1,005 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,245 | $5,149 | $9,052 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $41 | $173 | $304 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $466 | $2,268 | $3,169 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $198 | $355 | $511 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,414 | $1,414 | $1,414 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $397 | $710 | $1,022 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $160 | $245 | $413 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $466 | $996 | $1,263 |
| Septoplasty CPT 30520 • ENT | $657 | $1,764 | $2,871 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $242 | $606 | $970 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $222 | $540 | $858 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $273 | $698 | $1,123 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $288 | $1,078 | $1,869 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $423 | $929 | $1,435 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $798 | $916 | $975 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $42 | $607 | $1,172 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $42 | $857 | $1,672 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $1,303 | $1,403 | $1,504 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $337 | $1,293 | $2,249 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $42 | $1,195 | $2,349 |