| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $101 | $101 | $101 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $5 | $63 | $122 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $16 | $48 | $81 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $15 | $56 | $97 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $5 | $5 | $5 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $7 | $22 | $37 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $33 | $33 | $33 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $12 | $12 | $12 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $46 | $46 | $46 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $84 | $84 | $84 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $15 | $86 | $158 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $28 | $28 | $28 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $40 | $118 | $197 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $81 | $81 | $81 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $37 | $69 | $100 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $22 | $22 | $22 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $0 | $1 | $1 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $16 | $16 | $16 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $40 | $65 | $89 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $21 | $63 | $105 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $121 | $121 | $122 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $34 | $102 | $170 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $13 | $39 | $65 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $8 | $35 | $61 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $75 | $317 | $559 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $96 | $175 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $67 | $78 | $89 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $98 | $98 | $98 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $876 | $4,817 | $8,759 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $234 | $273 | $312 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,440 | $2,847 | $3,253 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $34 | $185 | $337 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $125 | $125 | $125 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $81 | $312 | $542 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $224 | $224 | $224 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $262 | $306 | $349 |
| Septoplasty CPT 30520 • ENT | $798 | $798 | $798 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $270 | $270 | $270 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $24 | $131 | $239 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $234 | $273 | $312 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $519 | $519 | $520 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $80 | $239 | $398 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $166 | $194 | $221 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $244 | $244 | $244 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $70 | $267 | $464 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $162 | $162 | $162 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $173 | $260 | $346 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $181 | $181 | $181 |