| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $82 | $82 | $82 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $242 | $242 | $242 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $4 | $33 | $90 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $75 | $121 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $52 | $52 | $52 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $59 | $59 | $59 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $158 | $158 | $158 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $132 | $132 | $132 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $30 | $194 | $342 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $132 | $132 | $132 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $89 | $148 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $286 | $286 | $286 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $186 | $311 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $252 | $252 | $252 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $131 | $131 | $131 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $102 | $102 | $102 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $10 | $20 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $164 | $199 | $235 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $129 | $223 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $30 | $85 | $118 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $86 | $104 | $122 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $94 | $94 | $94 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $14 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $4 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $52 | $62 | $67 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $54 | $111 | $168 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $98 | $364 | $629 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $22 | $93 | $163 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $11 | $40 | $68 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $140 | $495 | $851 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,202 | $4,268 | $7,335 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $24 | $28 | $33 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $274 | $1,928 | $2,764 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $176 | $193 | $211 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $904 | $904 | $904 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $328 | $393 | $458 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $152 | $165 | $191 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $334 | $574 |
| Septoplasty CPT 30520 • ENT | $30 | $721 | $1,334 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $177 | $177 | $177 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $161 | $259 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $351 | $760 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $30 | $216 | $401 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $311 | $592 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $172 | $212 | $291 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $394 | $431 | $468 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $746 | $746 | $746 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $196 | $277 | $384 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $337 | $574 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $229 | $428 |