| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $22 | $120 | $219 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $11 | $60 | $110 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $26 | $41 | $52 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $54 | $93 | $132 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $26 | $64 | $101 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $10 | $46 | $64 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $102 | $173 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $83 | $145 | $208 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $86 | $159 | $231 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $39 | $91 | $144 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $40 | $151 | $262 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $40 | $176 | $313 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $140 | $240 | $341 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $20 | $112 | $276 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $41 | $74 | $93 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $43 | $77 | $111 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $6 | $11 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $136 | $169 | $202 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $8 | $77 | $146 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $40 | $109 | $178 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $50 | $72 | $94 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $65 | $161 | $256 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $23 | $23 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $6 | $7 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $10 | $22 | $29 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $51 | $52 | $54 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $98 | $456 | $636 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $60 | $143 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $8 | $35 | $84 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $140 | $551 | $865 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $777 | $3,248 | $7,767 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $24 | $100 | $243 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,366 | $1,983 | $2,764 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $44 | $128 | $211 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $904 | $904 | $904 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $458 | $469 | $480 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $100 | $145 | $191 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $330 | $479 | $628 |
| Septoplasty CPT 30520 • ENT | $40 | $457 | $874 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $51 | $182 | $329 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $31 | $157 | $283 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $252 | $270 | $287 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $46 | $242 | $439 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $51 | $349 | $648 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $33 | $172 | $318 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $40 | $276 | $512 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $321 | $568 | $816 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $109 | $192 | $274 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $119 | $283 | $447 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $173 | $321 | $468 |