| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $54 | $71 | $88 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $159 | $159 | $159 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $69 | $93 | $102 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $58 | $71 | $84 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $43 | $43 | $43 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $51 | $66 | $80 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $131 | $131 | $131 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $129 | $143 | $157 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $122 | $134 | $146 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $142 | $142 | $142 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $203 | $203 | $203 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $241 | $241 | $241 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $201 | $261 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $135 | $135 | $135 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $95 | $100 | $105 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $49 | $52 | $56 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $4 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $117 | $138 | $158 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $81 | $102 | $116 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $120 | $138 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $74 | $74 | $74 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $72 | $72 | $72 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $14 | $19 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $13 | $45 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $53 | $62 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $81 | $385 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $70 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $42 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $79 | $93 | $109 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $985 | $4,528 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $31 | $116 | $202 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,280 | $2,544 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $201 | $201 | $201 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $786 | $786 | $786 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $435 | $617 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $181 | $267 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $291 | $495 | $725 |
| Septoplasty CPT 30520 • ENT | $666 | $1,162 | $1,658 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $242 | $389 | $536 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $71 | $265 | $458 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $276 | $449 | $623 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $298 | $686 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $436 | $613 | $790 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $189 | $216 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $347 | $347 | $347 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $550 | $550 | $550 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $149 | $168 | $188 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $316 | $513 | $709 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $329 | $534 | $740 |