| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $138 | $138 | $138 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $167 | $167 | $167 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $26 | $78 | $109 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $40 | $97 | $133 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $110 | $110 | $110 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $35 | $66 | $112 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $75 | $113 | $137 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $114 | $114 | $114 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $100 | $127 | $182 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $114 | $114 | $114 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $212 | $212 | $212 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $163 | $163 | $163 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $272 | $272 | $272 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $221 | $221 | $221 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $47 | $70 | $116 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $47 | $62 | $73 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $2 | $5 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $109 | $109 | $109 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $62 | $99 | $123 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $146 | $146 | $146 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $80 | $80 | $80 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $75 | $75 | $75 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $4 | $4 | $4 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $43 | $43 | $43 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $25 | $25 | $25 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $33 | $33 | $33 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $19 | $19 | $19 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $3 | $3 | $3 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $39 | $39 | $39 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $352 | $352 | $352 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $12 | $12 | $12 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $147 | $147 | $147 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $217 | $217 | $217 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $622 | $622 | $622 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $331 | $331 | $331 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $151 | $151 | $151 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $484 | $484 | $484 |
| Septoplasty CPT 30520 • ENT | $677 | $677 | $677 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $151 | $151 | $151 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $51 | $105 | $194 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $282 | $282 | $282 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $293 | $293 | $293 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $428 | $428 | $428 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $212 | $212 | $212 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $210 | $253 | $340 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $297 | $378 | $540 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $149 | $149 | $149 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $315 | $315 | $315 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $329 | $329 | $329 |