| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $20 | $81 | $122 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $24 | $183 | $404 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $4 | $114 | $263 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $70 | $160 | $317 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $6 | $140 | $275 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $7 | $63 | $120 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $73 | $203 | $332 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $79 | $243 | $406 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $61 | $253 | $446 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $74 | $223 | $373 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $45 | $236 | $514 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $35 | $315 | $594 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $123 | $317 | $637 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $19 | $174 | $328 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $36 | $71 | $141 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $102 | $174 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $10 | $17 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $81 | $260 | $438 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $5 | $129 | $294 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $72 | $173 | $344 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $38 | $138 | $301 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $157 | $160 | $166 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $25 | $36 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $10 | $34 | $63 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $38 | $222 | $554 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $101 | $167 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $29 | $74 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $50 | $83 | $100 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $440 | $5,415 | $9,031 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $15 | $194 | $325 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $317 | $1,268 | $2,382 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $160 | $215 | $243 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $60 | $239 | $419 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $78 | $213 | $348 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $24 | $110 | $161 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $355 | $392 | $466 |
| Septoplasty CPT 30520 • ENT | $98 | $788 | $1,774 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $19 | $233 | $571 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $34 | $232 | $490 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $62 | $312 | $669 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $42 | $295 | $635 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $228 | $459 | $845 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $30 | $217 | $470 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $49 | $328 | $693 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $383 | $584 | $986 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $39 | $214 | $504 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $203 | $419 | $765 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $211 | $506 | $801 |