| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $56 | $90 | $123 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $152 | $164 | $186 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $60 | $120 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $98 | $146 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $87 | $126 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $66 | $113 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $92 | $154 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $109 | $188 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $207 | $207 | $207 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $100 | $139 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $124 | $193 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $179 | $179 | $179 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $187 | $295 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $30 | $92 | $153 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $48 | $65 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $56 | $82 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $13 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $81 | $119 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $59 | $83 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $86 | $128 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $112 | $122 | $140 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $152 | $170 | $187 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $6 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $51 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $17 | $35 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $30 | $49 | $69 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $57 | $117 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $45 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $253 | $702 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $334 | $4,202 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $90 | $187 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $883 | $2,068 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $164 | $266 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $349 | $682 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $357 | $652 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $149 | $272 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $226 | $356 |
| Septoplasty CPT 30520 • ENT | $665 | $741 | $817 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $262 | $262 | $262 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $146 | $224 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $196 | $309 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $293 | $362 | $431 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $245 | $389 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $30 | $92 | $217 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $175 | $320 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $242 | $455 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $131 | $232 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $223 | $356 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $233 | $371 |