| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $42 | $168 | $355 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $10 | $190 | $429 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $2 | $53 | $103 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $72 | $162 | $343 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $27 | $160 | $294 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $34 | $180 | $325 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $6 | $125 | $236 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $34 | $168 | $303 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $59 | $271 | $482 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $100 | $247 | $395 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $69 | $255 | $558 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $77 | $256 | $436 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $186 | $283 | $477 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $9 | $226 | $579 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $35 | $99 | $163 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $9 | $68 | $155 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $4 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $102 | $269 | $435 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $40 | $148 | $315 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $51 | $175 | $374 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $38 | $134 | $288 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $7 | $123 | $185 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $16 | $22 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $5 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $28 | $35 | $39 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $10 | $33 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $62 | $396 | $643 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $102 | $146 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $8 | $59 | $86 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $82 | $353 | $890 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $731 | $5,484 | $7,860 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $24 | $87 | $209 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,809 | $1,831 | $1,843 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $23 | $130 | $211 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $224 | $525 | $825 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $47 | $252 | $457 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $25 | $114 | $190 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $53 | $434 | $725 |
| Septoplasty CPT 30520 • ENT | $34 | $1,173 | $1,827 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $55 | $409 | $635 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $64 | $365 | $572 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $23 | $460 | $734 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $34 | $767 | $1,192 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $63 | $602 | $953 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $17 | $239 | $530 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $247 | $558 | $781 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $79 | $705 | $1,115 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $34 | $299 | $469 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $268 | $607 | $844 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $196 | $451 | $877 |