| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $268 | $268 | $268 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $324 | $324 | $324 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $213 | $213 | $213 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $115 | $115 | $115 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $88 | $88 | $88 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $247 | $247 | $247 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $268 | $268 | $268 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $328 | $328 | $328 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $364 | $364 | $364 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $299 | $299 | $299 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $264 | $264 | $264 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $324 | $324 | $324 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $354 | $354 | $354 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $274 | $274 | $274 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $121 | $121 | $121 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $140 | $140 | $140 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $5 | $5 | $5 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $338 | $338 | $338 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $238 | $238 | $238 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $280 | $280 | $280 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $245 | $245 | $245 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $350 | $350 | $350 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $12 | $12 | $12 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $5 | $5 | $5 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $97 | $97 | $97 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $92 | $92 | $92 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $114 | $114 | $114 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $28 | $28 | $28 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $12 | $12 | $12 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $147 | $147 | $147 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,327 | $1,327 | $1,327 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $45 | $45 | $45 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $3,312 | $3,312 | $3,312 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $512 | $512 | $512 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,507 | $1,507 | $1,507 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $950 | $950 | $950 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $441 | $441 | $441 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $613 | $613 | $613 |
| Septoplasty CPT 30520 • ENT | $1,399 | $1,399 | $1,399 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $463 | $463 | $463 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $411 | $411 | $411 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $546 | $546 | $546 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $908 | $908 | $908 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $718 | $718 | $718 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $398 | $398 | $398 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $587 | $587 | $587 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $837 | $837 | $837 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $412 | $412 | $412 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $632 | $632 | $632 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $660 | $660 | $660 |