| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $151 | $151 | $151 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $182 | $182 | $182 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $101 | $107 | $120 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $50 | $57 | $63 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $50 | $88 | $126 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $44 | $91 | $139 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $80 | $115 | $151 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $102 | $113 | $125 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $50 | $127 | $204 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $124 | $133 | $141 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $50 | $143 | $237 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $50 | $163 | $275 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $50 | $196 | $296 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $50 | $147 | $244 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $104 | $118 | $133 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $65 | $65 | $65 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $7 | $7 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $50 | $120 | $189 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $50 | $92 | $134 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $50 | $113 | $157 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $138 | $138 | $138 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $195 | $195 | $195 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $5 | $6 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $2 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $6 | $29 | $46 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $3 | $20 | $36 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $31 | $243 | $455 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $63 | $118 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $26 | $49 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $41 | $324 | $607 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $350 | $2,708 | $5,066 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $11 | $96 | $181 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $924 | $1,475 | $2,000 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $139 | $139 | $139 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $420 | $420 | $420 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $228 | $300 | $336 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $112 | $150 | $187 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $50 | $246 | $345 |
| Septoplasty CPT 30520 • ENT | $50 | $414 | $779 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $258 | $259 | $261 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $50 | $63 | $77 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $50 | $121 | $192 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $50 | $278 | $506 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $50 | $222 | $393 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $205 | $209 | $218 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $50 | $186 | $321 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $430 | $444 | $459 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $145 | $194 | $231 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $50 | $199 | $349 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $325 | $344 | $364 |