| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $88 | $119 | $150 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $181 | $181 | $181 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $67 | $68 | $69 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $84 | $87 | $91 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $39 | $39 | $39 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $44 | $62 | $80 |
| 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 | $129 | $136 | $143 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $91 | $109 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $132 | $132 | $132 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $180 | $180 | $180 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $214 | $214 | $214 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $168 | $233 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $189 | $189 | $189 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $96 | $97 | $98 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $49 | $51 | $53 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $7 | $8 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $118 | $147 | $176 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $94 | $97 | $100 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $80 | $87 | $94 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $64 | $64 | $64 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $176 | $176 | $176 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $23 | $23 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $8 | $8 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $52 | $52 | $52 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $73 | $74 | $74 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $98 | $98 | $98 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $18 | $22 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $25 | $38 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $79 | $109 | $140 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,202 | $1,202 | $1,202 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $33 | $33 | $33 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $282 | $282 | $282 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $211 | $211 | $211 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $904 | $904 | $904 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $458 | $458 | $458 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $191 | $238 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $431 | $431 | $431 |
| Septoplasty CPT 30520 • ENT | $599 | $599 | $599 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $133 | $133 | $133 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $194 | $194 | $194 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $341 | $341 | $341 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $301 | $301 | $301 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $444 | $444 | $444 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $218 | $218 | $218 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $351 | $351 | $351 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $560 | $560 | $560 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $188 | $188 | $188 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $306 | $306 | $306 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $321 | $321 | $321 |