| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $117 | $117 | $117 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $141 | $141 | $141 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $51 | $51 | $51 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $67 | $67 | $67 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $53 | $53 | $53 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $63 | $63 | $63 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $97 | $97 | $97 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $113 | $113 | $113 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $129 | $129 | $129 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $111 | $111 | $111 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $135 | $135 | $135 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $155 | $155 | $155 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $164 | $164 | $164 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $137 | $137 | $137 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $78 | $78 | $78 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $53 | $53 | $53 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $9 | $9 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $175 | $175 | $175 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $52 | $60 | $77 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $88 | $88 | $88 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $32 | $32 | $32 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $115 | $115 | $115 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $24 | $24 | $24 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $6 | $6 | $6 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $50 | $50 | $50 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $58 | $58 | $58 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $91 | $91 | $91 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $21 | $21 | $21 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $10 | $10 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $130 | $130 | $130 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,116 | $1,116 | $1,116 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $35 | $35 | $35 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,567 | $2,567 | $2,567 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $201 | $201 | $201 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $749 | $749 | $749 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $297 | $297 | $297 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $165 | $165 | $165 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $299 | $299 | $299 |
| Septoplasty CPT 30520 • ENT | $387 | $387 | $387 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $157 | $157 | $157 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $136 | $136 | $136 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $254 | $254 | $254 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $243 | $243 | $243 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $361 | $361 | $361 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $175 | $175 | $175 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $284 | $284 | $284 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $455 | $455 | $455 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $201 | $201 | $201 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $346 | $346 | $346 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $376 | $376 | $376 |