| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $105 | $112 | $119 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $130 | $137 | $144 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $84 | $87 | $92 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $102 | $108 | $114 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $37 | $66 | $95 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $47 | $47 | $47 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $118 | $118 | $118 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $142 | $142 | $142 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $158 | $158 | $158 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $129 | $134 | $139 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $167 | $175 | $184 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $143 | $181 | $219 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $208 | $218 | $237 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $192 | $192 | $192 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $51 | $51 | $51 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $64 | $64 | $64 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $5 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $144 | $144 | $144 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $95 | $100 | $105 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $112 | $117 | $125 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $67 | $87 | $108 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $66 | $105 | $145 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $12 | $19 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $9 | $44 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $31 | $38 | $46 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $39 | $50 | $60 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $15 | $65 | $115 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $42 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $78 | $232 | $387 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $704 | $2,489 | $4,274 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $25 | $27 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,750 | $2,193 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $200 | $245 | $291 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $783 | $783 | $783 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $434 | $440 | $446 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $181 | $196 | $203 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $286 | $333 | $426 |
| Septoplasty CPT 30520 • ENT | $606 | $632 | $657 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $220 | $220 | $220 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $178 | $190 | $202 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $160 | $204 | $248 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $270 | $346 | $421 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $318 | $357 | $396 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $177 | $183 | $196 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $314 | $314 | $314 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $500 | $500 | $500 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $134 | $160 | $186 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $288 | $289 | $289 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $299 | $299 | $299 |