| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $83 | $101 | $120 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $57 | $57 | $57 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $72 | $78 | $83 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $47 | $47 | $47 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $100 | $100 | $100 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $31 | $31 | $31 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $120 | $120 | $120 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $101 | $101 | $101 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $162 | $162 | $162 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $90 | $90 | $90 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $80 | $80 | $80 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $190 | $190 | $190 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $38 | $97 | $155 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $83 | $83 | $83 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $96 | $96 | $96 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $39 | $47 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $16 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $150 | $150 | $150 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $74 | $92 | $110 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $87 | $112 | $138 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $76 | $76 | $76 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $143 | $143 | $143 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $3 | $3 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $3 | $4 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $30 | $33 | $36 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $18 | $18 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $280 | $280 | $280 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $82 | $82 | $82 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $18 | $18 | $18 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $36 | $36 | $36 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $525 | $525 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $97 | $97 | $97 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $924 | $1,459 | $1,995 |
| 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 | $41 | $154 | $268 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $112 | $158 | $203 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $271 | $365 | $458 |
| Septoplasty CPT 30520 • ENT | $619 | $619 | $619 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $144 | $144 | $144 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $42 | $42 | $42 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $242 | $242 | $242 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $363 | $363 | $363 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $312 | $312 | $312 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $160 | $176 | $192 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $255 | $255 | $255 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $252 | $252 | $252 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $90 | $156 | $223 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $245 | $245 | $245 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $200 | $200 | $200 |