| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $110 | $110 | $110 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $20 | $20 | $20 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $6 | $7 | $9 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $33 | $33 | $33 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $32 | $33 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $15 | $23 | $30 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $72 | $91 | $110 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $60 | $90 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $99 | $106 | $112 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $30 | $30 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $120 | $120 | $120 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $30 | $30 | $30 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $30 | $30 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $30 | $33 | $35 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $16 | $59 | $103 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $47 | $47 | $47 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $4 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $46 | $63 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $30 | $30 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $17 | $17 | $17 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $55 | $55 | $55 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $75 | $75 | $75 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $11 | $27 | $43 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $6 | $23 | $40 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $503 | $503 | $504 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $13 | $72 | $130 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $6 | $30 | $55 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $68 | $289 | $510 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $4,401 | $5,135 | $5,868 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $84 | $148 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $219 | $933 | $1,648 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $41 | $41 | $41 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $234 | $350 | $467 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $38 | $38 | $38 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $178 | $178 | $178 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $170 | $170 | $170 |
| Septoplasty CPT 30520 • ENT | $30 | $30 | $30 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $21 | $21 | $21 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $135 | $135 | $135 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $15 | $15 | $15 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $30 | $30 | $30 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $30 | $30 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $17 | $94 | $172 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $38 | $38 | $38 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $51 | $72 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $125 | $152 | $179 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $270 | $270 | $270 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $42 | $42 | $42 |