| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $133 | $133 | $133 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $161 | $161 | $161 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $105 | $149 | $172 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $129 | $129 | $129 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $110 | $110 | $110 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $51 | $142 | $232 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $100 | $117 | $134 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $113 | $139 | $164 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $181 | $241 | $301 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $148 | $148 | $148 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $131 | $131 | $131 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $112 | $179 | $247 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $190 | $229 | $267 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $217 | $217 | $217 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $85 | $101 | $117 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $41 | $49 | $58 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $9 | $11 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $163 | $163 | $163 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $118 | $118 | $118 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $91 | $97 | $104 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $123 | $123 | $123 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $176 | $176 | $176 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $7 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $11 | $34 | $78 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $38 | $46 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $61 | $376 | $691 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $96 | $179 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $8 | $8 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $81 | $550 | $1,019 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $722 | $4,397 | $8,072 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $26 | $127 | $228 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $268 | $2,223 | $3,359 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $275 | $275 | $275 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $833 | $924 | $1,015 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $48 | $272 | $452 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $177 | $200 | $223 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $300 | $407 | $514 |
| Septoplasty CPT 30520 • ENT | $683 | $683 | $683 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $151 | $151 | $151 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $215 | $215 | $215 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $275 | $275 | $275 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $446 | $446 | $446 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $353 | $353 | $353 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $178 | $184 | $196 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $262 | $276 | $289 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $373 | $393 | $413 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $192 | $199 | $205 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $314 | $314 | $314 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $326 | $326 | $326 |