| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $218 | $218 | $218 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $264 | $264 | $264 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $139 | $151 | $174 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $60 | $91 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $68 | $68 | $68 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $81 | $81 | $81 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $218 | $218 | $218 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $180 | $180 | $180 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $295 | $295 | $295 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $242 | $242 | $242 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $120 | $210 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $257 | $257 | $257 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $222 | $355 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $30 | $191 | $352 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $191 | $191 | $191 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $93 | $93 | $93 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $10 | $10 | $10 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $169 | $169 | $169 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $73 | $116 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $148 | $227 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $122 | $171 | $221 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $306 | $306 | $306 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $4 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $27 | $48 | $67 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $4 | $27 | $50 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $32 | $330 | $629 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $85 | $163 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $5 | $6 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $41 | $339 | $638 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $370 | $3,853 | $7,335 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $12 | $130 | $247 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $274 | $1,315 | $2,746 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $143 | $159 | $176 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $420 | $420 | $420 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $265 | $296 | $328 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $123 | $142 | $152 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $414 | $719 |
| Septoplasty CPT 30520 • ENT | $30 | $577 | $1,124 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $30 | $204 | $379 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $70 | $110 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $153 | $275 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $30 | $381 | $731 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $297 | $564 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $313 | $315 | $316 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $461 | $461 | $461 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $658 | $658 | $658 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $320 | $327 | $334 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $266 | $502 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $524 | $524 | $524 |