| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $119 | $119 | $119 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $125 | $139 | $153 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $29 | $34 | $41 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $77 | $100 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $34 | $39 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $38 | $47 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $75 | $120 |
| 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 | $162 | $252 | $342 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $58 | $86 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $96 | $162 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $189 | $189 | $189 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $209 | $224 | $240 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $195 | $195 | $195 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $61 | $91 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $47 | $57 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $13 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $80 | $130 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $72 | $95 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $68 | $98 | $114 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $91 | $104 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $66 | $66 | $66 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $41 | $72 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $12 | $20 | $28 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $61 | $79 | $96 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $12 | $22 | $31 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $33 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $60 | $350 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $573 | $1,022 | $1,472 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $110 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,438 | $2,153 | $2,867 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $210 | $210 | $210 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $815 | $815 | $815 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $456 | $628 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $190 | $190 | $191 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $207 | $440 |
| Septoplasty CPT 30520 • ENT | $614 | $631 | $648 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $135 | $135 | $135 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $96 | $193 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $190 | $329 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $348 | $348 | $348 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $175 | $320 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $152 | $184 | $215 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $229 | $394 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $175 | $319 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $84 | $184 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $296 | $574 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $162 | $295 |