| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $88 | $116 | $144 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $71 | $71 | $71 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $33 | $51 | $69 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $84 | $91 | $97 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $72 | $72 | $72 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $47 | $64 | $80 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $121 | $121 | $121 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $129 | $139 | $149 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $88 | $127 | $166 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $105 | $105 | $105 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $189 | $189 | $189 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $232 | $232 | $232 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $103 | $179 | $254 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $201 | $201 | $201 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $61 | $78 | $96 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $57 | $70 | $83 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $7 | $8 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $117 | $131 | $145 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $81 | $97 | $113 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $115 | $136 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $70 | $70 | $70 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $184 | $184 | $184 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $24 | $24 | $24 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $8 | $8 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $10 | $10 | $10 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $67 | $70 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $89 | $89 | $89 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $17 | $20 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $12 | $25 | $38 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $79 | $100 | $121 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,087 | $1,087 | $1,087 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $34 | $34 | $34 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,549 | $2,549 | $2,549 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $221 | $221 | $221 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $904 | $904 | $904 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $480 | $480 | $480 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $200 | $243 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $452 | $452 | $452 |
| Septoplasty CPT 30520 • ENT | $650 | $650 | $650 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $231 | $231 | $231 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $84 | $84 | $84 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $343 | $343 | $343 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $306 | $306 | $306 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $450 | $450 | $450 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $221 | $221 | $221 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $356 | $356 | $356 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $568 | $568 | $568 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $198 | $198 | $198 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $320 | $320 | $320 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $332 | $332 | $332 |