| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $69 | $109 | $150 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $5 | $106 | $181 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $27 | $63 | $109 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $4 | $80 | $165 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $41 | $81 | $121 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $90 | $147 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $18 | $181 | $408 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $57 | $198 | $339 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $12 | $191 | $369 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $57 | $257 | $458 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $60 | $276 | $631 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $55 | $369 | $731 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $18 | $329 | $783 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $22 | $335 | $649 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $93 | $216 | $368 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $9 | $92 | $175 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $9 | $21 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $34 | $286 | $539 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $5 | $151 | $362 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $15 | $126 | $263 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $15 | $153 | $369 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $35 | $239 | $498 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $17 | $22 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $5 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $38 | $50 | $75 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $10 | $40 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $64 | $74 | $94 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $61 | $145 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $8 | $35 | $86 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $126 | $561 | $889 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $786 | $3,248 | $7,860 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $27 | $114 | $279 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,842 | $2,148 | $2,761 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $31 | $196 | $401 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $67 | $557 | $1,047 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $62 | $466 | $869 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $25 | $171 | $362 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $355 | $609 | $1,073 |
| Septoplasty CPT 30520 • ENT | $491 | $1,145 | $2,453 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $37 | $294 | $551 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $119 | $318 | $678 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $153 | $450 | $925 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $175 | $664 | $1,584 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $42 | $542 | $1,168 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $34 | $362 | $650 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $34 | $496 | $958 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $395 | $879 | $1,364 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $34 | $361 | $687 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $201 | $504 | $1,043 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $34 | $563 | $1,092 |