| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $33 | $69 | $104 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $40 | $107 | $153 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $56 | $83 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $79 | $102 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $51 | $73 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $36 | $45 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $45 | $60 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $69 | $109 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $78 | $82 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $65 | $100 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $93 | $163 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $160 | $160 | $160 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $171 | $198 | $212 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $142 | $142 | $142 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $55 | $80 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $43 | $57 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $11 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $50 | $69 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $74 | $95 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $92 | $107 | $112 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $56 | $83 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $106 | $115 | $123 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $5 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $8 | $21 | $47 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $23 | $25 | $27 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $279 | $317 | $354 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $65 | $100 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $27 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $60 | $440 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $334 | $2,164 | $3,994 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $97 | $157 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $158 | $876 | $1,587 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $164 | $169 | $174 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $349 | $516 | $683 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $357 | $578 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $149 | $154 | $158 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $179 | $378 |
| Septoplasty CPT 30520 • ENT | $480 | $510 | $540 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $152 | $152 | $152 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $118 | $178 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $191 | $329 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $243 | $275 | $307 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $206 | $356 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $129 | $160 | $176 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $89 | $191 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $151 | $272 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $45 | $118 | $174 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $170 | $269 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $125 | $220 |