| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $84 | $84 | $84 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $104 | $104 | $104 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $4 | $25 | $67 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $56 | $81 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $25 | $25 | $25 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $54 | $78 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $86 | $86 | $86 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $105 | $105 | $105 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $30 | $54 | $78 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $63 | $97 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $56 | $82 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $99 | $99 | $99 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $137 | $216 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $137 | $137 | $137 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $36 | $36 | $36 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $46 | $46 | $46 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $3 | $4 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $71 | $112 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $38 | $46 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $68 | $118 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $79 | $101 | $122 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $42 | $42 | $42 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $4 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $27 | $53 | $67 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $21 | $36 | $50 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $210 | $419 | $629 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $86 | $163 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $23 | $46 | $68 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $85 | $224 | $364 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $283 | $3,809 | $7,335 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $24 | $60 | $97 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $827 | $1,877 | $2,746 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $163 | $170 | $176 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $154 | $154 | $154 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $268 | $298 | $328 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $132 | $145 | $152 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $174 | $292 |
| Septoplasty CPT 30520 • ENT | $30 | $243 | $456 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $30 | $66 | $103 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $78 | $126 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $101 | $173 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $30 | $96 | $162 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $122 | $215 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $120 | $155 | $172 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $177 | $177 | $177 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $251 | $251 | $251 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $130 | $163 | $196 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $114 | $197 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $206 | $206 | $206 |