| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $90 | $107 | $123 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $31 | $148 | $265 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $3 | $24 | $44 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $75 | $97 | $119 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $101 | $103 | $105 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $33 | $77 | $121 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $8 | $59 | $110 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $31 | $119 | $208 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $56 | $143 | $231 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $71 | $107 | $144 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $12 | $137 | $262 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $171 | $242 | $313 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $45 | $135 | $225 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $23 | $149 | $276 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $59 | $101 | $143 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $53 | $82 | $111 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $4 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $95 | $176 | $257 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $48 | $69 | $90 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $16 | $97 | $178 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $10 | $52 | $94 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $15 | $59 | $103 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $16 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $6 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $13 | $26 | $39 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $41 | $74 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $98 | $308 | $518 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $22 | $83 | $144 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $44 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $140 | $417 | $695 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $535 | $868 | $1,202 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $27 | $30 | $33 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $282 | $293 | $304 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $184 | $198 | $211 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $508 | $706 | $904 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $458 | $629 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $50 | $120 | $191 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $44 | $336 | $628 |
| Septoplasty CPT 30520 • ENT | $133 | $504 | $874 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $32 | $180 | $329 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $92 | $188 | $283 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $25 | $261 | $497 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $48 | $243 | $439 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $48 | $348 | $648 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $18 | $168 | $318 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $271 | $512 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $74 | $445 | $816 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $92 | $183 | $274 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $199 | $323 | $447 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $45 | $256 | $468 |