| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $133 | $133 | $133 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $161 | $161 | $161 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $58 | $68 | $72 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $49 | $49 | $49 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $35 | $48 | $61 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $72 | $72 | $72 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $111 | $111 | $111 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $129 | $129 | $129 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $148 | $148 | $148 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $128 | $128 | $128 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $154 | $154 | $154 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $121 | $121 | $121 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $129 | $193 | $258 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $99 | $99 | $99 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $88 | $88 | $88 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $61 | $61 | $61 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $10 | $10 | $10 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $141 | $171 | $201 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $54 | $84 | $115 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $69 | $103 | $138 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $40 | $40 | $40 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $149 | $149 | $149 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $20 | $24 | $29 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $6 | $7 | $9 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $38 | $43 | $53 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $50 | $66 | $82 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $69 | $91 | $112 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $26 | $92 | $158 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $13 | $52 | $92 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $156 | $554 | $953 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,373 | $4,954 | $8,535 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $30 | $36 | $43 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,250 | $2,803 | $3,159 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $298 | $298 | $298 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $862 | $862 | $862 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $478 | $504 | $530 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $197 | $208 | $219 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $399 | $440 | $481 |
| Septoplasty CPT 30520 • ENT | $516 | $516 | $516 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $148 | $180 | $212 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $182 | $182 | $182 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $339 | $339 | $339 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $322 | $322 | $322 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $478 | $478 | $478 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $221 | $225 | $232 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $354 | $365 | $376 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $564 | $583 | $603 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $50 | $143 | $242 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $297 | $297 | $297 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $323 | $323 | $323 |