| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $81 | $81 | $81 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $26 | $26 | $26 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $23 | $51 | $80 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $6 | $6 | $6 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $5 | $24 | $42 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $31 | $36 | $42 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $10 | $10 | $10 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $66 | $66 | $66 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $99 | $99 | $99 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $26 | $26 | $26 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $109 | $109 | $109 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $80 | $80 | $80 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $142 | $142 | $142 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $34 | $34 | $34 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $66 | $66 | $66 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $23 | $32 | $42 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $4 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $19 | $19 | $19 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $8 | $8 | $8 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $44 | $44 | $44 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $21 | $72 | $122 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $33 | $33 | $33 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $5 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $11 | $37 | $64 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $10 | $42 | $74 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $92 | $354 | $615 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $23 | $71 | $119 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $31 | $50 | $68 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $101 | $303 | $505 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $5,391 | $8,075 | $10,758 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $24 | $164 | $304 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $316 | $1,346 | $2,376 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $43 | $166 | $288 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $110 | $361 | $612 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $115 | $115 | $115 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $35 | $133 | $232 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $179 | $179 | $179 |
| Septoplasty CPT 30520 • ENT | $616 | $616 | $616 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $139 | $164 | $190 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $170 | $170 | $170 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $189 | $189 | $189 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $265 | $265 | $265 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $192 | $192 | $192 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $16 | $91 | $165 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $237 | $240 | $243 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $42 | $133 | $224 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $120 | $120 | $120 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $253 | $253 | $253 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $54 | $54 | $54 |