| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $9 | $81 | $123 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $31 | $143 | $246 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $5 | $66 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $58 | $90 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $21 | $55 | $104 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $22 | $62 | $101 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $15 | $109 | $203 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $15 | $74 | $133 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $84 | $177 | $270 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $71 | $119 | $168 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $19 | $67 | $152 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $101 | $154 | $222 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $110 | $253 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $61 | $128 | $201 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $12 | $62 | $113 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $40 | $48 | $57 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $7 | $10 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $31 | $53 | $76 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $83 | $109 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $13 | $85 | $212 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $22 | $81 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $15 | $106 | $152 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $13 | $44 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $46 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $336 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $60 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $29 | $57 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $464 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $3,150 | $8,072 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $114 | $203 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $304 | $1,423 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $108 | $228 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $203 | $680 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $228 | $476 | $799 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $50 | $184 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $117 | $291 |
| Septoplasty CPT 30520 • ENT | $30 | $364 | $1,033 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $75 | $214 | $352 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $101 | $181 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $25 | $105 | $260 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $30 | $170 | $432 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $175 | $336 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $26 | $120 | $175 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $206 | $241 | $259 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $185 | $391 | $619 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $132 | $219 | $306 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $180 | $298 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $233 | $265 | $297 |