| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $166 | $166 | $166 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $200 | $200 | $200 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $81 | $81 | $81 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $112 | $112 | $112 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $83 | $83 | $83 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $102 | $102 | $102 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $94 | $94 | $94 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $126 | $126 | $126 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $193 | $193 | $193 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $155 | $155 | $155 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $220 | $220 | $220 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $185 | $185 | $185 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $295 | $295 | $295 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $153 | $153 | $153 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $116 | $116 | $116 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $96 | $96 | $96 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $9 | $9 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $170 | $170 | $170 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $130 | $130 | $130 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $156 | $156 | $156 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $80 | $80 | $80 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $209 | $209 | $209 |
| 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 | $55 | $55 | $55 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $76 | $76 | $76 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $17 | $17 | $17 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $10 | $10 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $104 | $104 | $104 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $932 | $932 | $932 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $34 | $34 | $34 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $218 | $218 | $218 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $245 | $245 | $245 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $733 | $733 | $733 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $374 | $374 | $374 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $171 | $171 | $171 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $521 | $521 | $521 |
| Septoplasty CPT 30520 • ENT | $754 | $754 | $754 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $264 | $264 | $264 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $225 | $225 | $225 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $396 | $396 | $396 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $359 | $359 | $359 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $527 | $527 | $527 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $259 | $259 | $259 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $418 | $418 | $418 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $667 | $667 | $667 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $171 | $171 | $171 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $373 | $373 | $373 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $388 | $388 | $388 |