| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $88 | $122 | $154 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $62 | $62 | $62 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $54 | $64 | $69 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $72 | $80 | $84 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $33 | $67 | $101 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $67 | $76 | $80 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $62 | $71 | $79 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $118 | $125 | $129 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $73 | $97 | $131 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $62 | $87 | $112 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $92 | $92 | $92 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $173 | $173 | $173 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $111 | $127 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $98 | $98 | $98 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $80 | $90 | $96 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $49 | $55 | $60 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $5 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $117 | $127 | $146 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $81 | $81 | $82 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $95 | $97 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $43 | $68 | $93 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $58 | $58 | $58 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $18 | $18 | $18 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $6 | $6 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $7 | $7 | $7 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $58 | $68 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $77 | $86 | $94 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $18 | $22 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $28 | $38 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $79 | $103 | $121 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $944 | $944 | $944 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $26 | $31 | $36 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,172 | $2,172 | $2,172 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $161 | $161 | $161 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $710 | $710 | $710 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $350 | $350 | $350 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $146 | $239 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $319 | $368 | $416 |
| Septoplasty CPT 30520 • ENT | $581 | $606 | $632 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $129 | $129 | $129 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $184 | $186 | $189 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $202 | $237 | $273 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $310 | $321 | $331 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $166 | $313 | $460 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $82 | $153 | $225 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $237 | $300 | $363 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $171 | $375 | $580 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $188 | $188 | $188 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $300 | $309 | $318 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $286 | $310 | $333 |