| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $53 | $158 | $227 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $127 | $215 | $281 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $10 | $50 | $89 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $21 | $118 | $221 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $6 | $53 | $83 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $36 | $118 | $211 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $110 | $152 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $17 | $160 | $283 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $62 | $171 | $243 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $40 | $142 | $195 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $69 | $217 | $358 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $59 | $243 | $414 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $40 | $252 | $443 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $69 | $223 | $368 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $31 | $118 | $209 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $75 | $99 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $12 | $22 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $95 | $236 | $308 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $55 | $120 | $205 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $10 | $122 | $240 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $25 | $82 | $145 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $8 | $145 | $230 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $23 | $28 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $7 | $9 | $11 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $38 | $56 | $74 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $51 | $78 | $106 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $132 | $384 | $636 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $30 | $69 | $108 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $18 | $51 | $85 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $178 | $414 | $649 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,618 | $4,692 | $7,767 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $24 | $38 | $51 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,821 | $2,885 | $3,949 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $22 | $150 | $278 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $904 | $1,097 | $1,291 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $240 | $422 | $604 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $100 | $177 | $254 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $66 | $357 | $540 |
| Septoplasty CPT 30520 • ENT | $360 | $757 | $1,236 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $40 | $215 | $398 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $6 | $175 | $342 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $15 | $280 | $466 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $40 | $425 | $798 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $68 | $436 | $651 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $166 | $214 | $311 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $268 | $421 | $512 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $40 | $518 | $826 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $82 | $204 | $282 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $119 | $371 | $533 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $248 | $435 | $558 |