| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $142 | $149 | $156 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $189 | $189 | $189 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $69 | $69 | $69 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $93 | $93 | $93 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $73 | $73 | $73 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $46 | $46 | $46 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $78 | $78 | $78 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $148 | $148 | $148 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $165 | $165 | $165 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $137 | $137 | $137 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $115 | $115 | $115 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $148 | $148 | $148 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $160 | $160 | $160 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $195 | $195 | $195 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $69 | $86 | $95 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $49 | $56 | $66 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $9 | $11 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $144 | $144 | $144 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $95 | $98 | $103 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $125 | $125 | $125 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $67 | $67 | $67 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $179 | $179 | $179 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $22 | $22 | $22 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $6 | $6 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $44 | $44 | $44 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $68 | $68 | $68 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $84 | $84 | $84 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $19 | $19 | $19 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $10 | $10 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $120 | $120 | $120 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,030 | $1,030 | $1,030 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $28 | $28 | $28 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,369 | $2,369 | $2,369 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $181 | $181 | $181 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $774 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $392 | $392 | $392 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $163 | $163 | $163 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $448 | $448 | $448 |
| Septoplasty CPT 30520 • ENT | $622 | $622 | $622 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $232 | $232 | $232 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $200 | $200 | $200 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $209 | $209 | $209 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $320 | $320 | $320 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $475 | $475 | $475 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $232 | $232 | $232 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $375 | $375 | $375 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $598 | $598 | $598 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $146 | $146 | $146 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $320 | $320 | $320 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $337 | $337 | $337 |