| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $137 | $137 | $137 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $153 | $159 | $166 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $79 | $108 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $81 | $133 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $36 | $43 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $67 | $126 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $83 | $137 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $97 | $164 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $183 | $183 | $183 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $72 | $114 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $121 | $212 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $252 | $252 | $252 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $152 | $273 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $221 | $221 | $221 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $72 | $114 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $52 | $73 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $13 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $97 | $165 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $87 | $122 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $129 | $137 | $145 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $79 | $96 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $171 | $171 | $171 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $6 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $48 | $65 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $23 | $38 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $279 | $518 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $23 | $101 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $52 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $46 | $556 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $422 | $4,246 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $15 | $104 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $177 | $1,833 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $205 | $205 | $205 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $604 | $604 | $604 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $381 | $590 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $177 | $255 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $257 | $483 |
| Septoplasty CPT 30520 • ENT | $681 | $681 | $681 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $150 | $150 | $150 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $130 | $231 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $103 | $176 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $299 | $299 | $299 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $234 | $437 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $189 | $216 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $188 | $347 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $204 | $551 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $120 | $211 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $175 | $319 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $182 | $333 |