| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $112 | $112 | $112 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $100 | $100 | $100 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $61 | $61 | $61 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $80 | $80 | $80 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $65 | $65 | $65 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $29 | $29 | $29 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $77 | $77 | $77 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $138 | $138 | $138 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $107 | $107 | $107 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $125 | $125 | $125 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $121 | $121 | $121 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $141 | $141 | $141 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $108 | $108 | $108 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $83 | $83 | $83 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $91 | $91 | $91 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $53 | $53 | $53 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $4 | $4 | $4 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $104 | $104 | $104 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $41 | $41 | $41 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $87 | $87 | $87 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $75 | $75 | $75 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $43 | $43 | $43 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $21 | $21 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $7 | $7 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $51 | $51 | $51 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $37 | $37 | $37 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $78 | $78 | $78 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $18 | $18 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $10 | $10 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $61 | $61 | $61 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $525 | $525 | $525 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $17 | $17 | $17 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,235 | $2,235 | $2,235 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $203 | $203 | $203 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $774 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $342 | $342 | $342 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $175 | $175 | $175 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $188 | $188 | $188 |
| Septoplasty CPT 30520 • ENT | $399 | $399 | $399 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $219 | $219 | $219 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $184 | $184 | $184 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $156 | $156 | $156 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $162 | $162 | $162 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $388 | $388 | $388 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $192 | $192 | $192 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $308 | $308 | $308 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $252 | $252 | $252 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $133 | $133 | $133 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $283 | $283 | $283 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $294 | $294 | $294 |