| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $42 | $42 | $42 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $129 | $129 | $129 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $62 | $78 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $45 | $74 | $103 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $31 | $60 | $90 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $45 | $72 | $99 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $44 | $75 | $107 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $118 | $124 | $130 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $98 | $98 | $98 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $119 | $119 | $119 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $45 | $107 | $168 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $120 | $158 | $195 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $45 | $152 | $210 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $173 | $173 | $173 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $94 | $94 | $94 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $44 | $45 | $46 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $25 | $45 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $82 | $108 | $134 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $45 | $70 | $95 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $87 | $111 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $98 | $98 | $98 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $138 | $138 | $138 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $5 | $7 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $11 | $32 | $55 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $23 | $27 | $31 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $31 | $256 | $481 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $61 | $115 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $28 | $52 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $41 | $255 | $470 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $350 | $2,482 | $4,614 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $11 | $14 | $17 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $139 | $1,115 | $1,833 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $139 | $139 | $139 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $420 | $459 | $497 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $228 | $309 | $390 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $112 | $137 | $162 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $45 | $170 | $242 |
| Septoplasty CPT 30520 • ENT | $45 | $299 | $552 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $185 | $185 | $185 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $45 | $105 | $164 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $45 | $91 | $136 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $45 | $202 | $359 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $45 | $162 | $279 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $151 | $152 | $155 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $45 | $136 | $228 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $325 | $325 | $325 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $116 | $134 | $153 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $45 | $146 | $247 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $258 | $258 | $258 |