| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $185 | $185 | $185 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $121 | $121 | $121 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $100 | $115 | $147 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $179 | $179 | $179 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $44 | $44 | $44 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $30 | $100 | $171 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $81 | $81 | $81 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $94 | $94 | $94 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $251 | $251 | $251 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $206 | $206 | $206 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $181 | $181 | $181 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $127 | $127 | $127 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $238 | $241 | $243 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $188 | $188 | $188 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $30 | $38 | $45 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $96 | $96 | $96 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $3 | $3 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $118 | $118 | $118 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $109 | $137 | $164 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $129 | $161 | $193 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $38 | $38 | $38 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $253 | $253 | $253 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $19 | $29 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $5 | $8 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $13 | $44 | $73 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $53 | $74 | $95 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $33 | $361 | $690 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $25 | $102 | $178 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $13 | $44 | $76 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $158 | $427 | $695 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $382 | $4,226 | $8,071 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $13 | $20 | $27 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $959 | $2,347 | $3,041 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $241 | $241 | $241 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $782 | $782 | $782 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $304 | $552 | $800 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $195 | $264 | $333 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $291 | $356 | $421 |
| Septoplasty CPT 30520 • ENT | $962 | $962 | $962 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $99 | $99 | $99 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $148 | $148 | $148 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $270 | $270 | $270 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $368 | $368 | $368 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $491 | $491 | $491 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $176 | $177 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $287 | $287 | $287 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $459 | $459 | $459 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $151 | $169 | $188 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $250 | $250 | $250 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $452 | $452 | $452 |