| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $159 | $218 | $321 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $80 | $147 | $216 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $20 | $128 | $259 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $67 | $181 | $312 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $45 | $66 | $97 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $168 | $234 | $299 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $47 | $169 | $328 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $46 | $204 | $403 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $67 | $210 | $442 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $38 | $158 | $366 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $23 | $268 | $509 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $25 | $306 | $588 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $108 | $358 | $628 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $121 | $223 | $326 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $48 | $153 | $294 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $5 | $74 | $171 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $11 | $17 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $34 | $233 | $433 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $135 | $194 | $289 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $126 | $206 | $338 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $76 | $98 | $140 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $75 | $159 | $213 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $5 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $5 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $43 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $30 | $42 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $37 | $345 | $613 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $102 | $170 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $26 | $67 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $50 | $474 | $784 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $423 | $2,504 | $6,332 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $15 | $162 | $239 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $164 | $224 | $285 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $59 | $158 | $207 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $371 | $519 | $791 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $316 | $528 | $858 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $144 | $170 | $187 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $59 | $418 | $783 |
| Septoplasty CPT 30520 • ENT | $601 | $1,112 | $1,791 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $30 | $310 | $572 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $69 | $176 | $286 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $176 | $329 | $425 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $306 | $520 | $648 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $39 | $453 | $864 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $152 | $299 | $480 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $292 | $524 | $708 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $632 | $819 | $1,009 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $145 | $247 | $387 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $38 | $428 | $832 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $327 | $600 | $873 |