| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $46 | $74 | $101 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $56 | $110 | $153 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $28 | $45 | $77 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $70 | $93 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $67 | $104 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $36 | $41 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $72 | $114 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $64 | $98 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $154 | $154 | $154 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $77 | $105 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $118 | $177 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $141 | $141 | $141 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $155 | $179 | $191 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $118 | $118 | $118 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $61 | $91 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $53 | $76 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $13 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $74 | $162 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $74 | $104 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $81 | $95 | $103 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $67 | $85 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $64 | $111 | $157 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $13 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $6 | $6 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $47 | $56 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $12 | $37 | $63 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $78 | $384 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $92 | $167 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $54 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $106 | $653 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $953 | $4,992 | $9,031 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $30 | $190 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $335 | $2,184 | $3,176 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $194 | $219 | $243 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $774 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $421 | $610 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $161 | $166 | $176 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $269 | $421 |
| Septoplasty CPT 30520 • ENT | $491 | $543 | $596 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $219 | $219 | $219 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $92 | $172 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $137 | $205 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $208 | $236 | $265 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $241 | $388 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $152 | $165 | $192 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $169 | $308 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $260 | $490 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $107 | $184 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $201 | $289 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $162 | $294 |