| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $221 | $221 | $221 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $268 | $268 | $268 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $61 | $74 | $81 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $214 | $214 | $214 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $70 | $136 | $202 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $83 | $157 | $230 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $221 | $236 | $251 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $212 | $241 | $270 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $300 | $300 | $300 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $182 | $182 | $182 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $348 | $348 | $348 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $404 | $404 | $404 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $313 | $436 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $256 | $307 | $358 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $195 | $198 | $202 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $52 | $73 | $95 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $8 | $11 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $278 | $278 | $278 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $118 | $118 | $118 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $104 | $167 | $231 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $191 | $191 | $191 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $109 | $109 | $109 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $7 | $9 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $5 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $77 | $78 | $79 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $45 | $53 | $60 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $76 | $78 | $81 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $20 | $109 | $198 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $19 | $29 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $104 | $562 | $1,019 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $901 | $4,705 | $8,508 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $29 | $57 | $85 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $357 | $1,524 | $3,359 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $357 | $357 | $357 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,082 | $1,082 | $1,082 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $48 | $317 | $587 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $177 | $233 | $290 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $305 | $403 | $501 |
| Septoplasty CPT 30520 • ENT | $1,144 | $1,144 | $1,144 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $281 | $332 | $383 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $113 | $113 | $113 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $447 | $447 | $447 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $433 | $433 | $433 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $578 | $578 | $578 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $178 | $226 | $321 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $472 | $563 | $653 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $674 | $674 | $674 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $192 | $309 | $395 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $512 | $512 | $512 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $535 | $535 | $535 |