| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $135 | $190 | $299 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $72 | $135 | $167 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $11 | $66 | $113 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $9 | $44 | $79 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $16 | $67 | $118 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $5 | $38 | $59 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $47 | $146 | $299 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $115 | $172 | $250 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $132 | $197 | $342 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $54 | $151 | $248 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $9 | $151 | $293 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $76 | $171 | $266 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $126 | $218 | $311 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $65 | $184 | $304 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $67 | $72 | $80 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $28 | $48 | $63 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $7 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $174 | $177 | $182 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $85 | $152 | $223 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $15 | $90 | $165 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $121 | $193 | $266 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $7 | $83 | $159 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $7 | $9 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $4 | $5 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $43 | $76 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $37 | $67 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $59 | $69 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $18 | $18 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $41 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $498 | $934 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $722 | $3,310 | $5,898 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $26 | $28 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $268 | $288 | $308 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $44 | $119 | $194 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $270 | $470 | $671 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $397 | $666 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $188 | $193 | $197 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $123 | $431 | $680 |
| Septoplasty CPT 30520 • ENT | $648 | $991 | $1,552 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $15 | $355 | $536 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $48 | $189 | $304 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $188 | $388 | $760 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $43 | $533 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $317 | $506 | $790 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $88 | $235 | $440 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $26 | $311 | $646 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $185 | $556 | $921 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $126 | $276 | $384 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $189 | $393 | $574 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $57 | $361 | $730 |