| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $117 | $117 | $117 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $142 | $142 | $142 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $52 | $52 | $52 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $40 | $40 | $40 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $55 | $55 | $55 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $34 | $34 | $34 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $92 | $92 | $92 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $111 | $111 | $111 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $124 | $124 | $124 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $102 | $102 | $102 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $139 | $139 | $139 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $166 | $166 | $166 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $180 | $180 | $180 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $146 | $146 | $146 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $78 | $78 | $78 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $59 | $59 | $59 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $6 | $6 | $6 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $137 | $137 | $137 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $77 | $77 | $77 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $62 | $62 | $62 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $50 | $50 | $50 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $134 | $134 | $134 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $22 | $22 | $22 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $6 | $6 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $33 | $33 | $33 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $13 | $13 | $13 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $84 | $84 | $84 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $19 | $19 | $19 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $10 | $10 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $120 | $120 | $120 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,030 | $1,030 | $1,030 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $28 | $28 | $28 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,369 | $2,369 | $2,369 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $181 | $181 | $181 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $774 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $392 | $392 | $392 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $163 | $163 | $163 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $336 | $336 | $336 |
| Septoplasty CPT 30520 • ENT | $467 | $467 | $467 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $174 | $174 | $174 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $150 | $150 | $150 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $266 | $266 | $266 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $240 | $240 | $240 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $356 | $356 | $356 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $174 | $174 | $174 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $281 | $281 | $281 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $449 | $449 | $449 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $146 | $146 | $146 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $240 | $240 | $240 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $253 | $253 | $253 |