| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $108 | $108 | $109 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $135 | $230 | $324 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $4 | $28 | $76 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $106 | $183 | $260 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $128 | $225 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $247 | $247 | $247 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $177 | $177 | $177 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $328 | $328 | $328 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $364 | $364 | $364 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $299 | $299 | $299 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $171 | $297 | $423 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $492 | $492 | $492 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $42 | $261 | $530 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $274 | $274 | $274 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $237 | $237 | $237 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $140 | $140 | $140 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $13 | $13 | $13 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $338 | $338 | $338 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $145 | $145 | $145 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $114 | $169 | $280 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $108 | $176 | $245 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $146 | $146 | $146 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $8 | $12 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $5 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $12 | $27 | $42 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $40 | $54 | $67 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $114 | $308 | $503 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $28 | $79 | $130 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $12 | $34 | $55 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $147 | $328 | $510 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,327 | $3,598 | $5,868 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $45 | $121 | $197 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,196 | $2,568 | $3,312 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $195 | $353 | $512 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,507 | $1,507 | $1,507 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $363 | $657 | $950 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $168 | $259 | $441 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $300 | $404 | $613 |
| Septoplasty CPT 30520 • ENT | $686 | $1,042 | $1,399 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $463 | $463 | $463 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $189 | $300 | $411 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $257 | $303 | $349 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $444 | $491 | $538 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $326 | $522 | $718 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $181 | $253 | $398 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $267 | $427 | $587 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $837 | $837 | $837 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $190 | $301 | $412 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $287 | $460 | $632 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $660 | $660 | $660 |