| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $102 | $102 | $102 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $124 | $124 | $124 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $45 | $50 | $60 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $80 | $80 | $80 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $59 | $59 | $59 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $37 | $41 | $45 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $45 | $74 | $104 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $88 | $88 | $88 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $97 | $97 | $97 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $45 | $79 | $113 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $161 | $161 | $161 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $194 | $194 | $194 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $45 | $93 | $140 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $45 | $76 | $107 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $44 | $45 | $45 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $45 | $57 | $69 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $6 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $45 | $96 | $147 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $60 | $60 | $60 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $45 | $79 | $112 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $53 | $90 | $127 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $129 | $129 | $129 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $7 | $15 | $24 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $34 | $80 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $59 | $63 | $67 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $72 | $75 | $78 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $432 | $847 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $45 | $80 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $93 | $99 | $106 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $953 | $4,724 | $8,494 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $34 | $168 | $302 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $335 | $1,978 | $3,200 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $214 | $240 | $266 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $691 | $691 | $691 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $316 | $433 | $590 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $176 | $204 | $218 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $45 | $214 | $383 |
| Septoplasty CPT 30520 • ENT | $540 | $540 | $540 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $119 | $180 | $241 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $67 | $67 | $67 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $284 | $284 | $284 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $239 | $239 | $239 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $350 | $350 | $350 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $45 | $88 | $173 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $277 | $277 | $277 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $45 | $243 | $441 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $45 | $152 | $260 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $397 | $397 | $397 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $412 | $412 | $412 |