| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $66 | $77 | $88 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $203 | $203 | $203 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $69 | $88 | $133 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $84 | $123 | $162 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $53 | $65 | $77 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $80 | $117 | $154 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $167 | $167 | $167 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $114 | $149 | $204 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $146 | $187 | $227 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $138 | $138 | $138 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $263 | $263 | $263 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $167 | $183 | $199 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $204 | $329 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $271 | $271 | $271 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $74 | $85 | $96 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $39 | $58 | $87 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $6 | $8 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $118 | $164 | $210 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $90 | $92 | $94 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $100 | $110 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $154 | $154 | $154 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $216 | $216 | $216 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $6 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $4 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $31 | $55 | $76 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $49 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $31 | $360 | $688 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $68 | $182 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $39 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $41 | $351 | $933 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $350 | $4,106 | $7,863 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $11 | $145 | $278 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $924 | $2,362 | $3,082 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $139 | $139 | $139 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $420 | $420 | $420 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $228 | $293 | $359 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $112 | $198 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $240 | $266 | $293 |
| Septoplasty CPT 30520 • ENT | $865 | $865 | $865 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $192 | $192 | $192 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $257 | $257 | $257 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $338 | $338 | $338 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $563 | $563 | $563 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $437 | $437 | $437 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $177 | $199 | $243 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $357 | $357 | $357 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $510 | $510 | $510 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $179 | $218 | $256 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $388 | $388 | $388 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $404 | $404 | $404 |