| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $96 | $96 | $96 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $117 | $135 | $153 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $49 | $68 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $67 | $103 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $53 | $76 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $121 | $212 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $91 | $153 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $114 | $198 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $311 | $311 | $311 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $113 | $196 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $130 | $229 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $286 | $286 | $286 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $247 | $465 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $375 | $375 | $375 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $109 | $187 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $65 | $100 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $17 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $110 | $190 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $118 | $207 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $138 | $246 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $112 | $120 | $131 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $260 | $276 | $291 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $32 | $32 | $32 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $7 | $11 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $15 | $44 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $101 | $101 | $101 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $134 | $134 | $134 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $30 | $30 | $30 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $18 | $47 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $181 | $554 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,642 | $1,642 | $1,642 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $52 | $161 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $3,041 | $3,445 | $3,849 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $334 | $334 | $334 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,310 | $1,310 | $1,310 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $725 | $763 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $302 | $318 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $432 | $834 |
| Septoplasty CPT 30520 • ENT | $1,187 | $1,187 | $1,187 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $431 | $431 | $431 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $212 | $394 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $261 | $491 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $530 | $530 | $530 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $404 | $777 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $30 | $207 | $385 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $324 | $617 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $505 | $980 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $147 | $265 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $297 | $564 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $308 | $585 |