| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $89 | $104 | $118 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $30 | $86 | $143 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $14 | $24 | $33 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $44 | $79 | $114 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $33 | $66 | $99 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $40 | $74 | $109 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $53 | $85 | $118 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $19 | $58 | $98 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $16 | $62 | $108 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $10 | $53 | $97 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $82 | $98 | $114 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $106 | $161 | $215 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $113 | $172 | $232 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $57 | $87 | $118 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $50 | $77 | $104 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $9 | $35 | $61 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $3 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $92 | $124 | $157 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $11 | $37 | $63 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $11 | $67 | $123 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $25 | $67 | $108 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $33 | $47 | $62 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $6 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $22 | $34 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $26 | $32 | $38 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $204 | $361 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $12 | $12 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $29 | $53 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $351 | $642 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $2,939 | $5,354 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $105 | $192 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,385 | $1,485 | $1,585 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $22 | $115 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $50 | $340 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $318 | $330 | $342 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $18 | $93 | $169 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $96 | $181 | $267 |
| Septoplasty CPT 30520 • ENT | $577 | $593 | $609 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $135 | $156 | $177 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $164 | $173 | $181 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $129 | $184 | $238 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $262 | $329 | $396 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $70 | $188 | $307 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $44 | $107 | $171 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $143 | $197 | $251 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $41 | $199 | $358 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $22 | $101 | $180 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $273 | $293 | $314 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $49 | $167 | $284 |