| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $41 | $41 | $41 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $15 | $15 | $15 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $14 | $29 | $44 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $12 | $12 | $12 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $101 | $101 | $101 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $4 | $4 | $4 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $11 | $65 | $119 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $22 | $58 | $94 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $32 | $96 | $159 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $72 | $103 | $134 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $184 | $184 | $184 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $106 | $106 | $106 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $34 | $34 | $34 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $113 | $113 | $113 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $44 | $59 | $75 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $5 | $33 | $61 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $22 | $44 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $13 | $13 | $13 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $45 | $45 | $45 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $124 | $124 | $124 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $124 | $124 | $124 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $122 | $122 | $122 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $6 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $9 | $9 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $28 | $33 | $38 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $361 | $421 | $481 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $124 | $124 | $125 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $39 | $39 | $40 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $481 | $561 | $641 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $535 | $2,944 | $5,353 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $192 | $192 | $192 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $211 | $898 | $1,585 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $43 | $43 | $43 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $249 | $249 | $249 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $64 | $64 | $64 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $26 | $26 | $26 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $67 | $67 | $67 |
| Septoplasty CPT 30520 • ENT | $384 | $384 | $384 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $44 | $44 | $44 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $7 | $7 | $7 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $44 | $44 | $44 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $501 | $501 | $501 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $35 | $35 | $35 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $29 | $37 | $44 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $29 | $36 | $44 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $304 | $304 | $304 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $44 | $76 | $108 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $44 | $44 | $44 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $246 | $287 | $328 |