| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $102 | $102 | $102 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $66 | $66 | $66 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $72 | $90 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $128 | $128 | $128 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $213 | $213 | $213 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $51 | $51 | $51 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $254 | $254 | $254 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $213 | $213 | $213 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $177 | $177 | $177 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $211 | $211 | $211 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $205 | $205 | $205 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $465 | $465 | $465 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $238 | $370 | $502 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $122 | $190 | $258 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $55 | $55 | $55 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $71 | $71 | $71 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $4 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $94 | $148 | $202 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $109 | $167 | $225 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $129 | $197 | $265 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $65 | $65 | $65 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $141 | $141 | $141 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $6 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $4 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $11 | $46 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $29 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $370 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $98 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $41 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $92 | $100 | $109 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $4,322 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $35 | $153 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $346 | $2,143 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $205 | $205 | $205 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $823 | $823 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $380 | $590 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $190 | $262 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $291 | $462 | $725 |
| Septoplasty CPT 30520 • ENT | $672 | $1,165 | $1,658 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $292 | $414 | $536 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $389 | $424 | $458 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $515 | $569 | $623 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $857 | $966 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $674 | $732 | $790 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $189 | $216 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $346 | $407 | $468 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $786 | $786 | $786 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $188 | $198 | $208 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $317 | $513 | $709 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $329 | $329 | $329 |