| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $173 | $173 | $173 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $81 | $104 | $127 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $41 | $71 | $139 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $72 | $113 | $168 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $52 | $53 | $54 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $36 | $87 | $160 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $89 | $105 | $120 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $66 | $132 | $218 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $128 | $147 | $165 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $99 | $149 | $200 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $139 | $157 | $175 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $211 | $211 | $211 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $187 | $265 | $343 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $284 | $284 | $284 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $77 | $84 | $87 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $57 | $71 | $95 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $4 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $136 | $184 | $233 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $82 | $111 | $157 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $99 | $132 | $185 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $50 | $102 | $165 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $221 | $221 | $221 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $13 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $38 | $39 | $40 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $17 | $47 | $72 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $30 | $201 | $476 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $31 | $84 | $143 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $47 | $85 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $177 | $562 | $866 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $334 | $3,191 | $7,767 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $12 | $118 | $244 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $182 | $962 | $1,821 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $164 | $164 | $164 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $349 | $349 | $349 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $357 | $419 | $480 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $149 | $174 | $200 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $330 | $374 | $418 |
| Septoplasty CPT 30520 • ENT | $960 | $960 | $960 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $213 | $213 | $213 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $143 | $189 | $259 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $252 | $315 | $363 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $615 | $615 | $615 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $339 | $403 | $468 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $166 | $197 | $260 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $268 | $326 | $385 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $427 | $468 | $548 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $145 | $170 | $195 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $238 | $331 | $423 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $248 | $345 | $442 |