| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $5 | $43 | $82 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $11 | $56 | $100 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $33 | $96 | $155 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $89 | $104 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $8 | $36 | $64 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $106 | $182 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $40 | $99 | $198 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $20 | $113 | $239 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $126 | $211 | $266 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $104 | $213 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $135 | $221 | $307 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $29 | $198 | $367 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $36 | $153 | $270 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $40 | $180 | $321 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $4 | $84 | $165 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $52 | $79 | $106 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $12 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $14 | $89 | $163 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $13 | $78 | $113 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $129 | $169 | $209 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $22 | $67 | $111 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $9 | $58 | $107 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $13 | $45 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $30 | $41 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $473 | $691 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $23 | $112 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $52 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $46 | $278 | $695 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $422 | $3,100 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $15 | $81 | $202 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,179 | $2,420 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $74 | $137 | $201 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $508 | $648 | $788 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $437 | $618 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $33 | $108 | $182 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $17 | $359 | $701 |
| Septoplasty CPT 30520 • ENT | $333 | $667 | $1,002 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $30 | $133 | $217 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $37 | $183 | $330 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $25 | $220 | $414 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $65 | $258 | $451 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $48 | $354 | $661 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $18 | $173 | $326 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $271 | $524 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $432 | $834 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $141 | $224 | $307 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $43 | $259 | $476 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $297 | $397 | $497 |