| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $16 | $58 | $101 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $38 | $80 | $123 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $5 | $42 | $80 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $36 | $90 | $135 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $11 | $47 | $84 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $25 | $59 | $93 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $14 | $40 | $67 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $77 | $155 | $262 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $86 | $112 | $138 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $75 | $81 | $86 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $14 | $87 | $159 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $170 | $179 | $188 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $85 | $144 | $204 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $29 | $97 | $165 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $35 | $62 | $90 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $9 | $27 | $44 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $2 | $3 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $10 | $47 | $83 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $26 | $82 | $129 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $46 | $58 | $70 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $38 | $65 | $92 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $52 | $54 | $56 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $13 | $22 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $29 | $34 | $39 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $41 | $44 | $47 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $61 | $272 | $482 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $14 | $15 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $36 | $64 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $81 | $374 | $667 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $722 | $3,309 | $5,895 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $151 | $279 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,787 | $1,815 | $1,843 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $31 | $120 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $448 | $632 | $815 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $62 | $257 | $452 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $126 | $157 | $188 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $34 | $131 | $229 |
| Septoplasty CPT 30520 • ENT | $246 | $384 | $522 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $93 | $137 | $182 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $158 | $161 | $163 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $15 | $113 | $210 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $175 | $258 | $341 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $272 | $293 | $313 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $85 | $118 | $151 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $165 | $194 | $223 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $79 | $199 | $319 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $13 | $62 | $112 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $40 | $141 | $241 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $56 | $153 | $251 |