| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $21 | $86 | $132 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $10 | $96 | $149 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $12 | $64 | $98 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $50 | $93 | $128 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $105 | $107 | $110 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $10 | $59 | $114 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $76 | $99 | $123 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $102 | $103 | $103 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $30 | $77 | $124 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $101 | $119 | $137 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $10 | $127 | $208 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $45 | $136 | $226 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $156 | $211 | $266 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $16 | $71 | $125 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $5 | $57 | $110 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $5 | $31 | $54 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $2 | $3 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $23 | $90 | $156 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $36 | $79 | $109 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $56 | $86 | $111 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $28 | $63 | $106 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $123 | $143 | $153 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $6 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $35 | $43 | $54 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $26 | $27 | $28 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $35 | $46 | $61 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $75 | $116 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $15 | $38 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $42 | $45 | $47 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $382 | $1,612 | $3,994 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $13 | $56 | $140 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,190 | $1,450 | $1,787 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $27 | $136 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $342 | $445 | $548 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $39 | $244 | $389 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $81 | $142 | $188 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $189 | $254 | $378 |
| Septoplasty CPT 30520 • ENT | $374 | $518 | $640 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $136 | $187 | $237 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $8 | $133 | $213 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $100 | $161 | $223 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $40 | $176 | $245 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $204 | $296 | $356 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $35 | $131 | $182 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $45 | $198 | $282 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $40 | $175 | $416 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $17 | $126 | $188 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $135 | $231 | $289 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $197 | $262 | $327 |