| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $29 | $83 | $120 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $25 | $84 | $144 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $3 | $123 | $257 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $99 | $115 | $131 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $4 | $137 | $269 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $25 | $160 | $296 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $9 | $111 | $213 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $94 | $247 | $397 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $28 | $201 | $436 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $23 | $146 | $269 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $214 | $358 | $502 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $40 | $165 | $377 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $326 | $622 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $124 | $222 | $321 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $45 | $91 | $138 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $11 | $98 | $170 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $4 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $132 | $280 | $428 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $70 | $142 | $185 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $65 | $201 | $336 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $23 | $188 | $322 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $10 | $94 | $179 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $7 | $9 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $4 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $37 | $63 | $96 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $41 | $75 | $117 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $66 | $371 | $598 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $20 | $30 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $33 | $49 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $88 | $454 | $671 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $769 | $2,684 | $5,847 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $26 | $139 | $196 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $263 | $735 | $1,652 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $29 | $240 | $411 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $274 | $504 | $733 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $43 | $357 | $608 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $18 | $214 | $372 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $130 | $728 | $1,117 |
| Septoplasty CPT 30520 • ENT | $530 | $1,087 | $2,141 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $67 | $274 | $481 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $38 | $327 | $592 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $40 | $429 | $808 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $40 | $711 | $1,382 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $213 | $616 | $1,019 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $40 | $273 | $567 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $40 | $369 | $836 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $33 | $518 | $1,190 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $89 | $284 | $436 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $185 | $542 | $938 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $138 | $560 | $982 |