| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $54 | $71 | $88 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $159 | $159 | $159 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $69 | $94 | $119 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $84 | $115 | $146 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $43 | $43 | $43 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $80 | $100 | $119 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $131 | $131 | $131 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $129 | $143 | $157 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $140 | $207 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $169 | $169 | $169 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $203 | $203 | $203 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $241 | $241 | $241 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $140 | $176 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $159 | $159 | $159 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $96 | $115 | $135 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $49 | $52 | $56 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $4 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $107 | $113 | $118 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $83 | $88 | $94 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $98 | $102 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $132 | $132 | $132 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $164 | $164 | $164 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $19 | $19 | $19 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $50 | $50 | $50 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $46 | $60 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $62 | $62 | $62 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $14 | $15 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $23 | $38 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $79 | $80 | $82 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $730 | $730 | $730 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $31 | $31 | $31 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,310 | $2,310 | $2,310 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $201 | $201 | $201 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $630 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $397 | $397 | $397 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $184 | $235 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $353 | $353 | $353 |
| Septoplasty CPT 30520 • ENT | $806 | $806 | $806 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $242 | $242 | $242 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $71 | $71 | $71 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $314 | $314 | $314 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $521 | $521 | $521 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $427 | $427 | $427 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $216 | $216 | $216 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $349 | $349 | $349 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $499 | $499 | $499 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $171 | $171 | $171 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $316 | $316 | $316 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $387 | $387 | $387 |