| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $142 | $142 | $142 |
| 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 | $6 | $38 | $101 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $122 | $122 | $122 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $107 | $107 | $107 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $44 | $80 | $116 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $124 | $125 | $127 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $95 | $125 | $156 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $172 | $172 | $172 |
| 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 | $197 | $197 | $197 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $222 | $225 | $228 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $244 | $311 | $445 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $202 | $202 | $202 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $110 | $150 | $190 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $65 | $66 | $67 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $38 | $39 | $40 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $163 | $165 | $167 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $122 | $122 | $122 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $131 | $167 | $237 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $112 | $112 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $141 | $141 | $141 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $8 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $56 | $67 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $53 | $53 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $370 | $443 | $515 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $178 | $178 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $56 | $66 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $92 | $390 | $687 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $6,565 | $6,565 | $6,565 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $205 | $238 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,264 | $2,417 | $2,708 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $219 | $219 | $219 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $507 | $652 | $797 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $323 | $353 | $384 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $180 | $206 | $257 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $330 | $486 | $800 |
| Septoplasty CPT 30520 • ENT | $754 | $754 | $754 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $215 | $215 | $215 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $207 | $207 | $207 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $283 | $283 | $283 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $488 | $488 | $488 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $364 | $364 | $364 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $201 | $308 | $361 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $259 | $278 | $298 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $397 | $411 | $425 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $211 | $401 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $311 | $311 | $311 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $325 | $325 | $325 |