| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $10 | $10 | $10 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $31 | $31 | $31 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $17 | $58 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $112 | $112 | $112 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $6 | $6 | $6 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $8 | $25 | $42 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $84 | $84 | $84 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $66 | $102 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $56 | $56 | $56 |
| 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 | $83 | $83 | $83 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $66 | $66 | $66 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $48 | $48 | $48 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $122 | $147 | $171 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $59 | $59 | $59 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $23 | $32 | $42 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $1 | $1 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $44 | $44 | $44 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $21 | $21 | $21 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $90 | $90 | $90 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $56 | $56 | $56 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $9 | $9 | $9 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $4 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $78 | $91 | $104 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $53 | $58 | $62 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $75 | $383 | $691 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $178 | $179 | $179 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $8 | $32 | $57 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $65 | $380 | $695 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $5,354 | $7,203 | $9,052 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $228 | $249 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $213 | $259 | $304 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $43 | $43 | $43 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $40 | $274 | $509 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $400 | $599 | $799 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $50 | $50 | $50 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $17 | $17 | $17 |
| Septoplasty CPT 30520 • ENT | $44 | $44 | $44 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $182 | $182 | $182 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $138 | $138 | $138 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $171 | $171 | $171 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $36 | $36 | $36 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $30 | $30 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $132 | $153 | $175 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $36 | $36 | $36 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $42 | $160 | $277 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $28 | $28 | $28 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $285 | $285 | $285 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $42 | $43 | $45 |