| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $88 | $103 | $119 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $58 | $58 | $58 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $27 | $48 | $69 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $80 | $82 | $84 |
| 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 | $73 | $76 | $80 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $100 | $100 | $100 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $123 | $126 | $129 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $85 | $98 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $111 | $111 | $111 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $102 | $102 | $102 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $130 | $130 | $130 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $123 | $143 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $166 | $166 | $166 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $83 | $90 | $96 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $49 | $53 | $57 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $6 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $118 | $135 | $152 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $31 | $83 | $113 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $103 | $112 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $58 | $58 | $58 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $152 | $152 | $152 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $15 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $5 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $47 | $51 | $55 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $53 | $61 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $76 | $383 | $691 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $55 | $134 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $42 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $79 | $370 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $932 | $3,493 | $6,054 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $29 | $116 | $203 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $218 | $1,250 | $2,281 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $190 | $279 | $369 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $895 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $412 | $606 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $172 | $263 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $374 | $374 | $374 |
| Septoplasty CPT 30520 • ENT | $537 | $537 | $537 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $191 | $191 | $191 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $163 | $163 | $163 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $284 | $284 | $284 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $253 | $253 | $253 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $372 | $372 | $372 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $183 | $183 | $183 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $294 | $294 | $294 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $469 | $469 | $469 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $164 | $164 | $164 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $264 | $264 | $264 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $275 | $275 | $275 |