| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $251 | $251 | $251 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $124 | $124 | $124 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $45 | $45 | $45 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $138 | $138 | $138 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $59 | $59 | $59 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $127 | $127 | $127 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $104 | $143 | $183 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $151 | $151 | $151 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $207 | $225 | $243 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $203 | $203 | $203 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $167 | $167 | $167 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $215 | $215 | $215 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $233 | $233 | $233 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $290 | $290 | $290 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $151 | $151 | $151 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $67 | $92 | $117 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $8 | $10 | $12 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $269 | $269 | $269 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $94 | $115 | $135 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $187 | $187 | $187 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $101 | $101 | $101 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $270 | $270 | $270 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $33 | $33 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $10 | $10 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $14 | $14 | $14 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $18 | $18 | $18 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $140 | $140 | $140 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $32 | $32 | $32 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $16 | $16 | $16 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $199 | $199 | $199 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,459 | $1,459 | $1,459 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $46 | $46 | $46 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $3,949 | $3,949 | $3,949 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $299 | $299 | $299 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,408 | $1,408 | $1,408 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $490 | $490 | $490 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $242 | $242 | $242 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $359 | $511 | $663 |
| Septoplasty CPT 30520 • ENT | $816 | $864 | $913 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $349 | $349 | $349 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $226 | $263 | $300 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $321 | $422 | $524 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $457 | $457 | $457 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $400 | $538 | $675 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $331 | $331 | $331 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $329 | $431 | $534 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $468 | $660 | $851 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $213 | $213 | $213 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $364 | $414 | $465 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $379 | $433 | $488 |