| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $50 | $69 | $88 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $152 | $152 | $152 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $69 | $70 | $71 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $84 | $90 | $96 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $34 | $34 | $34 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $45 | $62 | $80 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $122 | $122 | $122 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $129 | $139 | $150 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $88 | $102 | $116 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $135 | $135 | $135 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $190 | $190 | $190 |
| 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 | $136 | $168 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $128 | $128 | $128 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $95 | $96 | $97 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $49 | $66 | $83 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $6 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $118 | $129 | $139 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $81 | $97 | $114 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $114 | $135 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $74 | $74 | $74 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $182 | $182 | $182 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $23 | $23 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $7 | $7 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $34 | $34 | $34 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $49 | $61 | $73 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $76 | $76 | $76 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $16 | $17 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $24 | $38 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $79 | $91 | $104 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $931 | $931 | $931 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $34 | $34 | $34 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,183 | $2,183 | $2,183 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $193 | $193 | $193 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $593 | $593 | $593 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $359 | $359 | $359 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $166 | $226 | $285 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $454 | $454 | $454 |
| Septoplasty CPT 30520 • ENT | $641 | $641 | $641 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $236 | $236 | $236 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $200 | $200 | $200 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $340 | $340 | $340 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $288 | $288 | $288 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $422 | $422 | $422 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $209 | $209 | $209 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $335 | $335 | $335 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $533 | $533 | $533 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $199 | $199 | $199 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $306 | $306 | $306 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $319 | $319 | $319 |