| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $9 | $104 | $200 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $8 | $125 | $242 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $12 | $48 | $83 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $32 | $35 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $17 | $29 | $42 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $31 | $36 | $42 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $7 | $24 | $42 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $26 | $89 | $153 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $99 | $105 | $112 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $89 | $89 | $89 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $21 | $92 | $164 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $20 | $31 | $42 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $42 | $140 | $238 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $76 | $76 | $76 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $8 | $25 | $42 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $34 | $38 | $42 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $3 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $26 | $34 | $42 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $19 | $24 | $30 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $74 | $101 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $13 | $38 | $64 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $58 | $97 | $136 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $48 | $51 | $55 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $47 | $54 | $62 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $565 | $628 | $691 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $184 | $184 | $184 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $77 | $79 | $81 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $927 | $966 | $1,005 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $905 | $4,979 | $9,052 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $30 | $117 | $203 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,376 | $2,772 | $3,168 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $30 | $114 | $198 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $550 | $783 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $79 | $79 | $79 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $32 | $96 | $160 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $466 | $466 | $466 |
| Septoplasty CPT 30520 • ENT | $66 | $361 | $657 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $72 | $72 | $72 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $111 | $167 | $222 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $26 | $149 | $273 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $58 | $173 | $288 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $42 | $233 | $423 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $42 | $126 | $209 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $42 | $105 | $168 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $42 | $61 | $80 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $221 | $221 | $221 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $68 | $202 | $337 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $42 | $196 | $351 |