| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $9 | $53 | $97 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $31 | $138 | $246 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $7 | $84 | $162 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $37 | $61 | $85 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $4 | $34 | $64 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $34 | $35 | $36 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $12 | $108 | $203 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $80 | $97 | $114 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $124 | $127 | $131 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $80 | $91 | $101 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $59 | $105 | $152 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $13 | $64 | $115 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $156 | $173 | $190 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $12 | $84 | $156 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $21 | $32 | $43 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $41 | $49 | $57 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $3 | $3 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $76 | $85 | $94 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $48 | $78 | $109 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $25 | $44 | $63 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $22 | $105 | $187 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $16 | $71 | $125 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $6 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $38 | $47 | $55 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $26 | $27 | $28 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $37 | $42 | $47 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $15 | $18 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $6 | $8 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $51 | $72 | $93 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $437 | $622 | $807 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $142 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $167 | $660 | $1,154 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $288 | $369 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $823 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $342 | $371 | $400 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $141 | $154 | $167 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $124 | $219 |
| Septoplasty CPT 30520 • ENT | $86 | $569 | $1,051 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $22 | $66 | $111 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $28 | $88 | $148 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $25 | $142 | $259 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $86 | $385 | $683 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $141 | $252 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $18 | $156 | $295 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $47 | $240 | $434 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $55 | $175 | $294 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $28 | $124 | $220 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $214 | $342 | $471 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $233 | $234 | $235 |