| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $217 | $217 | $217 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $269 | $269 | $269 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $175 | $175 | $175 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $210 | $210 | $210 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $182 | $182 | $182 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $200 | $200 | $200 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $223 | $223 | $223 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $269 | $269 | $269 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $296 | $296 | $296 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $184 | $184 | $184 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $204 | $204 | $204 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $246 | $246 | $246 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $419 | $419 | $419 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $350 | $350 | $350 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $197 | $197 | $197 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $116 | $116 | $116 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $12 | $12 | $12 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $288 | $288 | $288 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $199 | $199 | $199 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $231 | $231 | $231 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $212 | $212 | $212 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $103 | $103 | $103 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $8 | $8 | $8 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $3 | $3 | $3 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $22 | $22 | $22 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $53 | $53 | $53 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $628 | $628 | $628 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $244 | $244 | $244 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $53 | $53 | $53 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $1,088 | $1,088 | $1,088 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $707 | $707 | $707 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $290 | $290 | $290 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,069 | $2,069 | $2,069 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $544 | $544 | $544 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $872 | $872 | $872 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $873 | $873 | $873 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $361 | $361 | $361 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $289 | $289 | $289 |
| Septoplasty CPT 30520 • ENT | $1,151 | $1,151 | $1,151 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $382 | $382 | $382 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $326 | $326 | $326 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $437 | $437 | $437 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $742 | $742 | $742 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $519 | $519 | $519 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $290 | $290 | $290 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $427 | $427 | $427 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $606 | $606 | $606 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $230 | $230 | $230 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $487 | $487 | $487 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $509 | $509 | $509 |