| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $123 | $131 | $138 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $152 | $162 | $171 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $38 | $68 | $99 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $119 | $127 | $134 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $42 | $73 | $104 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $51 | $82 | $113 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $124 | $132 | $141 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $152 | $162 | $172 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $127 | $147 | $167 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $117 | $128 | $139 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $135 | $164 | $193 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $163 | $193 | $222 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $178 | $207 | $237 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $198 | $211 | $224 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $78 | $102 | $127 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $65 | $69 | $74 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $4 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $163 | $174 | $186 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $64 | $69 | $74 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $91 | $109 | $128 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $112 | $114 | $116 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $64 | $108 | $152 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $6 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $55 | $64 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $27 | $40 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $492 | $591 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $107 | $143 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $60 | $68 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $494 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $934 | $4,502 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $164 | $217 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,947 | $2,494 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $230 | $299 | $368 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $69 | $542 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $336 | $567 | $799 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $154 | $244 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $291 | $310 | $329 |
| Septoplasty CPT 30520 • ENT | $665 | $708 | $752 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $215 | $228 | $242 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $183 | $195 | $208 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $250 | $267 | $284 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $431 | $458 | $485 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $317 | $337 | $358 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $187 | $199 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $259 | $276 | $294 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $369 | $393 | $418 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $151 | $169 | $188 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $284 | $304 | $324 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $297 | $318 | $339 |