| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $22 | $67 | $112 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $106 | $121 | $136 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $31 | $58 | $92 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $11 | $53 | $100 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $17 | $41 | $66 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $16 | $54 | $106 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $88 | $106 | $117 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $20 | $92 | $143 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $116 | $157 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $65 | $95 | $125 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $11 | $62 | $112 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $20 | $148 | $213 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $168 | $232 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $37 | $78 | $118 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $5 | $49 | $91 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $9 | $45 | $60 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $4 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $108 | $117 | $126 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $77 | $92 | $104 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $75 | $89 | $112 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $61 | $64 | $67 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $32 | $99 | $165 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $10 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $48 | $53 | $56 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $45 | $50 | $59 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $78 | $396 | $555 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $80 | $146 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $40 | $63 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $60 | $371 | $754 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $953 | $4,020 | $6,346 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $30 | $143 | $228 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $335 | $1,545 | $2,457 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $194 | $237 | $279 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $50 | $441 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $421 | $425 | $427 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $176 | $185 | $195 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $41 | $231 | $421 |
| Septoplasty CPT 30520 • ENT | $596 | $680 | $764 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $24 | $133 | $243 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $42 | $120 | $184 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $144 | $216 | $329 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $28 | $146 | $265 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $55 | $222 | $388 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $102 | $166 | $205 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $45 | $177 | $308 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $322 | $414 | $490 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $29 | $81 | $133 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $283 | $291 | $299 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $294 | $307 | $314 |