| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $16 | $16 | $16 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $19 | $19 | $19 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $12 | $32 | $52 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $11 | $11 | $11 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $29 | $34 | $39 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $32 | $36 | $40 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $45 | $45 | $45 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $11 | $11 | $11 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $67 | $67 | $67 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $54 | $54 | $54 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $9 | $9 | $9 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $86 | $128 | $171 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $65 | $65 | $65 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $15 | $56 | $97 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $44 | $65 | $87 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $7 | $7 | $7 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $1 | $3 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $102 | $105 | $108 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $8 | $8 | $8 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $67 | $67 | $67 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $50 | $50 | $50 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $40 | $40 | $40 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $23 | $23 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $6 | $6 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $28 | $33 | $38 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $39 | $45 | $51 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $64 | $270 | $476 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $143 | $143 | $144 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $63 | $74 | $84 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $87 | $476 | $865 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $5,825 | $6,796 | $7,767 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $24 | $103 | $182 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,820 | $1,820 | $1,821 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $111 | $111 | $111 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $90 | $497 | $903 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $48 | $48 | $48 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $20 | $20 | $20 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $247 | $247 | $247 |
| Septoplasty CPT 30520 • ENT | $240 | $240 | $240 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $125 | $125 | $125 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $71 | $71 | $71 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $15 | $15 | $15 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $23 | $23 | $23 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $254 | $254 | $254 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $17 | $91 | $166 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $201 | $201 | $201 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $86 | $86 | $86 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $109 | $109 | $109 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $40 | $40 | $40 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $248 | $248 | $248 |