| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $119 | $185 | $221 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $144 | $156 | $169 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $63 | $117 | $275 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $84 | $124 | $163 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $291 | $291 | $291 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $49 | $106 | $156 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $91 | $143 | $172 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $168 | $221 | $291 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $101 | $186 | $233 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $143 | $143 | $143 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $167 | $189 | $212 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $403 | $403 | $403 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $167 | $218 | $261 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $132 | $132 | $132 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $46 | $51 | $57 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $59 | $70 | $79 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $6 | $8 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $167 | $272 | $441 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $120 | $140 | $153 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $87 | $139 | $230 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $73 | $117 | $160 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $180 | $227 | $274 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $16 | $27 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $6 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $22 | $46 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $7 | $34 | $60 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $379 | $711 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $84 | $160 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $41 | $71 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $388 | $714 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $382 | $4,536 | $8,690 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $159 | $301 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $271 | $1,211 | $3,056 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $278 | $295 | $313 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $687 | $747 | $808 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $446 | $484 | $504 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $127 | $181 | $208 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $311 | $369 | $398 |
| Septoplasty CPT 30520 • ENT | $559 | $722 | $885 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $32 | $157 | $281 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $175 | $258 | $340 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $297 | $322 | $346 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $249 | $394 | $539 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $365 | $466 | $566 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $181 | $225 | $315 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $32 | $247 | $463 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $32 | $554 | $1,077 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $203 | $251 | $300 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $310 | $408 | $505 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $527 | $527 | $527 |