| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $127 | $127 | $127 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $153 | $153 | $154 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $62 | $100 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $30 | $51 | $73 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $30 | $42 | $54 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $50 | $70 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $30 | $69 | $96 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $30 | $74 | $117 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $157 | $157 | $157 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $30 | $62 | $126 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $30 | $87 | $144 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $143 | $154 | $165 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $30 | $103 | $177 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $150 | $150 | $150 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $52 | $74 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $30 | $41 | $63 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $15 | $30 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $30 | $130 | $198 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $30 | $68 | $109 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $76 | $102 | $129 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $51 | $82 | $112 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $149 | $149 | $149 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $21 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $6 | $11 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $73 | $74 | $74 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $53 | $79 | $106 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $132 | $411 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $30 | $104 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $18 | $57 | $77 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $92 | $399 | $927 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,618 | $4,844 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $51 | $174 | $270 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $304 | $2,431 | $3,949 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $278 | $278 | $278 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,015 | $1,153 | $1,291 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $604 | $702 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $254 | $294 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $30 | $165 | $300 |
| Septoplasty CPT 30520 • ENT | $436 | $436 | $436 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $135 | $135 | $135 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $30 | $73 | $115 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $30 | $131 | $232 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $281 | $281 | $281 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $30 | $225 | $420 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $184 | $200 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $30 | $180 | $330 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $30 | $281 | $532 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $30 | $106 | $182 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $30 | $164 | $297 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $30 | $176 | $322 |