| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $328 | $328 | $328 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $398 | $398 | $398 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $89 | $181 | $261 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $141 | $215 | $253 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $107 | $167 | $197 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $126 | $199 | $236 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $216 | $305 | $349 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $275 | $366 | $412 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $445 | $454 | $458 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $366 | $384 | $393 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $517 | $521 | $523 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $411 | $540 | $606 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $432 | $580 | $653 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $334 | $472 | $540 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $148 | $236 | $279 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $171 | $197 | $209 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $16 | $20 | $22 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $261 | $429 | $513 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $287 | $289 | $291 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $218 | $300 | $341 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $152 | $212 | $333 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $199 | $380 | $471 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $45 | $65 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $16 | $22 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $52 | $52 | $52 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $5 | $5 | $5 |
| 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 | $5 | $5 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $63 | $63 | $63 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $573 | $573 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $19 | $19 | $19 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $216 | $216 | $216 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $451 | $572 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $823 | $823 | $823 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $456 | $979 | $1,241 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $190 | $408 | $517 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $478 | $970 | $1,216 |
| Septoplasty CPT 30520 • ENT | $1,697 | $1,700 | $1,707 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $567 | $618 | $643 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $171 | $425 | $552 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $424 | $806 | $996 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $907 | $974 | $1,108 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $872 | $1,187 | $1,344 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $484 | $599 | $656 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $713 | $944 | $1,060 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $1,017 | $1,469 | $1,695 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $411 | $483 | $536 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $769 | $860 | $906 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $803 | $901 | $951 |