| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $119 | $126 | $134 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $146 | $157 | $167 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $36 | $84 | $109 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $124 | $128 | $131 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $102 | $102 | $102 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $118 | $118 | $118 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $119 | $119 | $119 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $98 | $98 | $98 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $109 | $109 | $109 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $108 | $108 | $108 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $186 | $199 | $212 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $143 | $180 | $216 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $257 | $262 | $264 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $119 | $119 | $119 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $35 | $70 | $104 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $58 | $58 | $58 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $7 | $7 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $175 | $178 | $181 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $105 | $113 | $121 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $124 | $136 | $142 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $109 | $112 | $116 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $147 | $152 | $157 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $13 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $38 | $47 | $60 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $10 | $26 | $41 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $54 | $66 | $79 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $98 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $43 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $51 | $373 | $695 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $961 | $3,667 | $6,373 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $33 | $152 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $304 | $1,653 | $2,402 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $174 | $191 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $525 | $525 | $525 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $285 | $396 | $452 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $141 | $172 | $188 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $170 | $294 | $356 |
| Septoplasty CPT 30520 • ENT | $654 | $734 | $814 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $205 | $205 | $205 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $67 | $145 | $224 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $188 | $247 | $307 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $282 | $404 | $525 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $390 | $402 | $413 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $172 | $202 | $217 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $328 | $328 | $328 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $361 | $361 | $361 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $34 | $125 | $181 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $305 | $326 | $346 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $317 | $317 | $317 |