| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $51 | $69 | $88 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $156 | $156 | $156 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $41 | $72 | $102 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $72 | $125 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $81 | $108 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $44 | $89 | $119 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $129 | $129 | $129 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $129 | $143 | $157 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $124 | $174 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $143 | $143 | $143 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $202 | $202 | $202 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $153 | $153 | $153 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $135 | $167 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $130 | $130 | $130 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $65 | $95 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $57 | $62 | $67 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $6 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $118 | $140 | $162 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $76 | $110 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $114 | $134 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $107 | $107 | $107 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $150 | $150 | $150 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $4 | $4 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $29 | $29 | $29 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $29 | $51 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $39 | $39 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $12 | $13 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $21 | $38 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $51 | $65 | $79 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $437 | $437 | $437 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $14 | $14 | $14 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $173 | $173 | $173 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $174 | $174 | $174 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $525 | $525 | $525 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $285 | $285 | $285 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $141 | $213 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $292 | $292 | $292 |
| Septoplasty CPT 30520 • ENT | $665 | $665 | $665 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $223 | $223 | $223 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $165 | $181 | $198 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $260 | $295 | $329 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $252 | $252 | $252 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $336 | $336 | $336 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $187 | $187 | $187 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $275 | $275 | $275 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $392 | $392 | $392 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $197 | $197 | $197 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $298 | $298 | $298 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $311 | $311 | $311 |