| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $204 | $204 | $204 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $247 | $247 | $247 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $59 | $73 | $81 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $196 | $196 | $196 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $28 | $95 | $162 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $91 | $138 | $186 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $100 | $116 | $133 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $122 | $183 | $244 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $87 | $179 | $271 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $112 | $166 | $221 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $198 | $198 | $198 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $178 | $277 | $375 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $231 | $272 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $95 | $212 | $329 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $38 | $100 | $162 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $41 | $65 | $88 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $7 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $247 | $247 | $247 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $115 | $115 | $115 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $104 | $159 | $215 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $117 | $117 | $117 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $255 | $255 | $255 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $14 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $51 | $69 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $37 | $49 | $60 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $60 | $412 | $764 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $106 | $198 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $45 | $83 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $78 | $548 | $1,019 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $704 | $4,606 | $8,508 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $25 | $28 | $30 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,750 | $2,823 | $3,359 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $264 | $264 | $264 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $497 | $648 | $800 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $48 | $241 | $434 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $177 | $195 | $214 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $305 | $518 | $732 |
| Septoplasty CPT 30520 • ENT | $1,035 | $1,035 | $1,035 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $227 | $227 | $227 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $348 | $348 | $348 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $430 | $430 | $430 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $457 | $457 | $457 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $670 | $670 | $670 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $178 | $229 | $331 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $532 | $532 | $532 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $846 | $846 | $846 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $192 | $256 | $320 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $490 | $490 | $490 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $509 | $509 | $509 |