| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $16 | $16 | $16 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $19 | $19 | $19 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $8 | $45 | $82 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $100 | $100 | $100 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $44 | $44 | $44 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $47 | $47 | $47 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $103 | $103 | $103 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $94 | $94 | $94 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $97 | $97 | $97 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $83 | $99 | $115 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $40 | $40 | $40 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $83 | $134 | $185 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $30 | $30 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $20 | $20 | $20 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $9 | $24 | $40 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $27 | $27 | $27 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $0 | $0 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $20 | $20 | $20 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $40 | $40 | $40 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $16 | $16 | $16 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $117 | $117 | $117 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $82 | $82 | $82 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $8 | $9 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $3 | $4 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $44 | $52 | $59 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $48 | $48 | $49 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $59 | $329 | $599 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $16 | $85 | $154 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $36 | $66 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $602 | $602 | $603 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $5,248 | $6,122 | $6,996 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $129 | $234 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,977 | $1,977 | $1,977 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $96 | $144 | $192 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $274 | $411 | $548 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $84 | $84 | $84 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $17 | $96 | $174 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $31 | $31 | $31 |
| Septoplasty CPT 30520 • ENT | $591 | $591 | $591 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $39 | $39 | $39 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $8 | $8 | $8 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $225 | $225 | $225 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $58 | $58 | $58 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $284 | $284 | $284 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $32 | $95 | $158 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $233 | $233 | $233 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $66 | $66 | $66 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $40 | $64 | $89 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $265 | $265 | $265 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $28 | $28 | $28 |