| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $152 | $152 | $152 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $189 | $189 | $189 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $42 | $42 | $42 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $148 | $148 | $148 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $46 | $46 | $46 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $141 | $141 | $141 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $104 | $104 | $104 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $191 | $191 | $191 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $142 | $142 | $142 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $132 | $132 | $132 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $150 | $150 | $150 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $280 | $280 | $280 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $300 | $300 | $300 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $249 | $249 | $249 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $141 | $141 | $141 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $83 | $83 | $83 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $8 | $8 | $8 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $121 | $121 | $121 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $84 | $84 | $84 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $163 | $163 | $163 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $142 | $142 | $142 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $190 | $190 | $190 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $3 | $3 | $3 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $1 | $1 | $1 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $31 | $31 | $31 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $2 | $2 | $2 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $259 | $259 | $259 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $8 | $8 | $8 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $2 | $2 | $2 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $36 | $36 | $36 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $334 | $334 | $334 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $10 | $10 | $10 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $883 | $883 | $883 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $164 | $164 | $164 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $154 | $154 | $154 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $357 | $357 | $357 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $132 | $132 | $132 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $362 | $362 | $362 |
| Septoplasty CPT 30520 • ENT | $829 | $829 | $829 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $186 | $186 | $186 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $79 | $79 | $79 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $314 | $314 | $314 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $533 | $533 | $533 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $395 | $395 | $395 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $220 | $220 | $220 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $325 | $325 | $325 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $462 | $462 | $462 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $168 | $168 | $168 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $361 | $361 | $361 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $377 | $377 | $377 |