| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $189 | $209 | $228 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $276 | $276 | $276 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $150 | $160 | $179 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $75 | $128 | $182 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $158 | $173 | $189 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $71 | $71 | $71 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $125 | $176 | $228 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $75 | $152 | $229 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $122 | $211 | $342 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $193 | $193 | $193 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $121 | $121 | $121 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $141 | $141 | $141 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $100 | $217 | $363 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $372 | $372 | $372 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $68 | $120 | $171 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $39 | $46 | $53 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $3 | $4 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $113 | $173 | $232 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $42 | $115 | $223 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $81 | $84 | $86 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $71 | $71 | $71 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $302 | $302 | $302 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $52 | $52 | $52 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $5 | $5 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $47 | $47 | $47 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $12 | $12 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $7 | $7 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $81 | $81 | $81 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $525 | $525 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $23 | $23 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,787 | $1,787 | $1,787 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $208 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $630 | $630 | $630 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $452 | $452 | $452 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $188 | $188 | $188 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $440 | $478 | $515 |
| Septoplasty CPT 30520 • ENT | $1,173 | $1,253 | $1,334 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $258 | $258 | $258 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $122 | $158 | $193 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $156 | $458 | $760 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $765 | $765 | $765 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $202 | $202 | $202 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $112 | $112 | $112 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $192 | $224 | $255 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $235 | $235 | $235 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $352 | $368 | $384 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $209 | $391 | $574 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $187 | $187 | $187 |