| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $163 | $163 | $163 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $197 | $197 | $197 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $41 | $59 | $67 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $88 | $101 | $127 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $95 | $95 | $95 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $60 | $60 | $60 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $108 | $108 | $108 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $148 | $165 | $200 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $82 | $118 | $155 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $181 | $181 | $181 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $257 | $257 | $257 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $204 | $204 | $204 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $216 | $256 | $337 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $270 | $270 | $270 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $61 | $77 | $99 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $28 | $58 | $77 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $10 | $12 | $15 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $235 | $235 | $235 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $101 | $117 | $151 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $115 | $116 | $117 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $97 | $97 | $97 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $239 | $239 | $239 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $21 | $21 | $21 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $7 | $7 | $7 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $36 | $36 | $36 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $59 | $59 | $59 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $78 | $78 | $78 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $18 | $18 | $18 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $10 | $10 | $10 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $106 | $106 | $106 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $953 | $953 | $953 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $30 | $30 | $30 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,235 | $2,235 | $2,235 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $194 | $194 | $194 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $774 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $421 | $421 | $421 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $176 | $176 | $176 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $611 | $611 | $611 |
| Septoplasty CPT 30520 • ENT | $864 | $864 | $864 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $318 | $318 | $318 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $107 | $107 | $107 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $454 | $454 | $454 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $384 | $384 | $384 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $563 | $563 | $563 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $278 | $278 | $278 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $446 | $446 | $446 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $711 | $711 | $711 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $267 | $267 | $267 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $410 | $410 | $410 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $426 | $426 | $426 |