| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $102 | $102 | $102 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $123 | $138 | $153 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $116 | $202 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $69 | $109 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $122 | $213 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $132 | $234 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $98 | $167 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $170 | $310 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $235 | $235 | $235 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $120 | $211 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $215 | $400 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $465 | $465 | $465 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $182 | $334 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $258 | $258 | $258 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $72 | $115 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $70 | $110 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $12 | $21 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $116 | $202 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $128 | $225 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $129 | $148 | $168 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $112 | $169 | $226 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $323 | $323 | $323 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $52 | $63 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $38 | $38 | $38 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $49 | $49 | $49 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $12 | $12 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $5 | $41 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $495 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $573 | $573 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $145 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $216 | $1,628 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $210 | $210 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $823 | $823 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $456 | $628 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $190 | $262 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $444 | $725 |
| Septoplasty CPT 30520 • ENT | $1,319 | $1,489 | $1,658 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $438 | $487 | $536 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $292 | $458 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $327 | $623 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $857 | $966 | $1,075 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $498 | $790 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $242 | $374 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $409 | $646 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $579 | $921 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $249 | $389 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $445 | $709 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $464 | $740 |