| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $3 | $3 | $3 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $11 | $11 | $11 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $7 | $41 | $74 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $18 | $18 | $18 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $12 | $12 | $12 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $17 | $17 | $17 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $12 | $12 | $12 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $12 | $48 | $84 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $94 | $115 | $136 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $11 | $11 | $11 |
| 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 | $117 | $117 | $117 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $36 | $36 | $36 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $15 | $15 | $15 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $34 | $98 | $162 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $28 | $41 | $54 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $0 | $0 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $19 | $19 | $19 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $24 | $24 | $24 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $6 | $6 | $6 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $121 | $121 | $121 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $49 | $49 | $49 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $8 | $9 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $3 | $4 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $57 | $67 | $76 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $31 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $68 | $378 | $689 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $137 | $159 | $182 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $77 | $77 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $700 | $817 | $933 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $786 | $4,325 | $7,863 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $27 | $118 | $209 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,311 | $2,311 | $2,311 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $110 | $110 | $110 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $81 | $81 | $81 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $179 | $179 | $179 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $20 | $20 | $20 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $208 | $208 | $208 |
| Septoplasty CPT 30520 • ENT | $502 | $502 | $502 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $32 | $32 | $32 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $6 | $6 | $6 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $34 | $34 | $34 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $24 | $24 | $24 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $323 | $323 | $323 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $34 | $106 | $177 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $34 | $147 | $260 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $278 | $278 | $278 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $34 | $162 | $289 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $189 | $189 | $189 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $378 | $378 | $378 |