| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $233 | $233 | $233 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $117 | $117 | $117 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $68 | $74 | $80 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $105 | $165 | $224 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $51 | $118 | $185 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $24 | $118 | $212 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $24 | $128 | $233 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $174 | $227 | $280 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $135 | $223 | $311 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $122 | $159 | $196 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $219 | $290 | $361 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $253 | $341 | $429 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $273 | $369 | $465 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $24 | $199 | $375 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $84 | $136 | $187 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $87 | $106 | $125 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $10 | $10 | $11 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $174 | $182 | $190 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $121 | $126 | $132 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $143 | $194 | $246 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $131 | $131 | $131 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $291 | $291 | $291 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $32 | $32 | $32 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $11 | $11 | $11 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $62 | $62 | $62 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $101 | $101 | $101 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $134 | $134 | $134 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $30 | $30 | $30 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $18 | $18 | $18 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $181 | $181 | $181 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,642 | $1,642 | $1,642 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $52 | $52 | $52 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $3,849 | $3,849 | $3,849 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $334 | $334 | $334 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,310 | $1,333 | $1,355 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $725 | $725 | $725 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $302 | $302 | $302 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $516 | $675 | $834 |
| Septoplasty CPT 30520 • ENT | $712 | $949 | $1,187 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $159 | $295 | $431 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $127 | $180 | $232 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $422 | $457 | $491 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $388 | $459 | $530 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $578 | $677 | $777 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $281 | $333 | $385 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $454 | $536 | $617 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $24 | $502 | $980 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $24 | $194 | $365 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $382 | $473 | $564 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $402 | $494 | $585 |