| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $43 | $43 | $43 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $45 | $45 | $45 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $74 | $79 | $90 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $169 | $169 | $169 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $88 | $147 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $41 | $41 | $41 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $175 | $175 | $175 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $85 | $85 | $85 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $138 | $138 | $138 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $82 | $98 | $115 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $100 | $100 | $100 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $122 | $122 | $122 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $45 | $194 | $344 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $176 | $176 | $176 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $41 | $97 | $154 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $49 | $62 | $75 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $2 | $2 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $137 | $137 | $137 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $155 | $155 | $155 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $73 | $85 | $97 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $95 | $108 | $122 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $226 | $226 | $226 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $6 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $3 | $5 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $34 | $50 | $76 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $29 | $52 | $74 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $43 | $151 | $259 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $23 | $49 | $76 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $16 | $40 | $63 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $38 | $56 | $75 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $5,641 | $10,758 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $13 | $15 | $17 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,154 | $2,384 | $4,027 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $278 | $283 | $288 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $525 | $525 | $525 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $359 | $402 | $446 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $141 | $190 | $232 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $32 | $94 | $157 |
| Septoplasty CPT 30520 • ENT | $542 | $542 | $542 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $174 | $174 | $174 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $158 | $158 | $158 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $128 | $128 | $128 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $348 | $348 | $348 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $269 | $269 | $269 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $158 | $171 | $177 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $260 | $316 | $373 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $41 | $287 | $532 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $25 | $123 | $187 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $255 | $255 | $255 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $249 | $256 | $263 |