| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $132 | $132 | $132 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $66 | $66 | $66 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $30 | $30 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $77 | $77 | $77 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $61 | $61 | $61 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $72 | $72 | $72 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $111 | $111 | $111 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $130 | $130 | $130 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $148 | $148 | $148 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $128 | $128 | $128 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $92 | $92 | $92 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $178 | $178 | $178 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $189 | $189 | $189 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $157 | $157 | $157 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $65 | $65 | $65 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $46 | $46 | $46 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $9 | $9 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $204 | $204 | $204 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $88 | $88 | $88 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $101 | $101 | $101 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $32 | $32 | $32 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $123 | $123 | $123 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $33 | $33 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $10 | $10 | $10 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $70 | $70 | $70 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $71 | $71 | $71 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $126 | $126 | $126 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $29 | $29 | $29 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $15 | $15 | $15 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $180 | $180 | $180 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,545 | $1,545 | $1,545 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $46 | $46 | $46 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $355 | $355 | $355 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $253 | $253 | $253 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,162 | $1,162 | $1,162 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $549 | $549 | $549 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $229 | $229 | $229 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $483 | $483 | $483 |
| Septoplasty CPT 30520 • ENT | $628 | $628 | $628 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $256 | $256 | $256 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $102 | $102 | $102 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $411 | $411 | $411 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $505 | $505 | $505 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $754 | $754 | $754 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $360 | $360 | $360 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $593 | $593 | $593 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $958 | $958 | $958 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $230 | $230 | $230 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $423 | $423 | $423 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $458 | $458 | $458 |