| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $189 | $189 | $189 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $229 | $229 | $229 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $147 | $147 | $147 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $182 | $182 | $182 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $150 | $150 | $150 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $172 | $172 | $172 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $188 | $188 | $188 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $162 | $162 | $162 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $179 | $179 | $179 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $159 | $159 | $159 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $294 | $294 | $294 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $350 | $350 | $350 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $258 | $258 | $258 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $306 | $306 | $306 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $143 | $147 | $151 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $102 | $102 | $102 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $9 | $9 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $157 | $157 | $157 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $77 | $122 | $168 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $200 | $200 | $200 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $106 | $106 | $106 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $103 | $103 | $103 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $23 | $23 | $23 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $7 | $7 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $10 | $10 | $10 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $52 | $52 | $52 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $65 | $65 | $65 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $16 | $16 | $16 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $8 | $8 | $8 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $84 | $84 | $84 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $763 | $763 | $763 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $25 | $25 | $25 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $284 | $284 | $284 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $216 | $216 | $216 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $848 | $848 | $848 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $470 | $470 | $470 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $196 | $196 | $196 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $681 | $681 | $681 |
| Septoplasty CPT 30520 • ENT | $972 | $972 | $972 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $211 | $211 | $211 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $104 | $104 | $104 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $402 | $402 | $402 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $437 | $437 | $437 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $641 | $641 | $641 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $316 | $316 | $316 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $509 | $509 | $509 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $810 | $810 | $810 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $298 | $298 | $298 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $465 | $465 | $465 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $482 | $482 | $482 |