| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $39 | $64 | $88 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $153 | $188 | $224 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $25 | $56 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $65 | $84 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $31 | $31 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $79 | $113 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $46 | $62 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $128 | $226 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $131 | $139 | $146 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $57 | $112 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $93 | $156 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $339 | $339 | $339 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $87 | $127 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $100 | $111 | $122 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $62 | $96 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $48 | $60 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $10 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $98 | $146 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $71 | $109 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $109 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $91 | $102 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $105 | $105 | $105 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $13 | $18 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $6 | $51 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $25 | $50 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $365 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $67 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $48 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $79 | $511 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $437 | $4,254 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $185 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,154 | $2,412 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $140 | $140 | $140 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $548 | $548 | $548 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $350 | $575 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $141 | $253 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $226 | $421 |
| Septoplasty CPT 30520 • ENT | $512 | $512 | $512 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $213 | $213 | $213 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $157 | $283 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $185 | $341 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $368 | $368 | $368 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $245 | $460 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $208 | $273 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $216 | $402 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $305 | $580 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $109 | $188 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $130 | $230 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $135 | $240 |