| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $68 | $68 | $68 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $204 | $204 | $204 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $38 | $38 | $38 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $114 | $114 | $114 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $84 | $84 | $84 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $55 | $55 | $55 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $143 | $143 | $143 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $175 | $175 | $175 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $139 | $139 | $139 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $158 | $158 | $158 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $145 | $145 | $145 |
| 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 | $299 | $299 | $299 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $236 | $236 | $236 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $118 | $118 | $118 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $69 | $69 | $69 |
| 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 | $133 | $133 | $133 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $159 | $159 | $159 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $82 | $82 | $82 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $216 | $216 | $216 |
| 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 | $47 | $47 | $47 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $12 | $12 | $12 |
| 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 | $29 | $29 | $29 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,185 | $2,185 | $2,185 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $190 | $190 | $190 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $774 | $774 | $774 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $412 | $412 | $412 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $172 | $172 | $172 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $531 | $531 | $531 |
| Septoplasty CPT 30520 • ENT | $763 | $763 | $763 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $271 | $271 | $271 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $231 | $231 | $231 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $237 | $237 | $237 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $359 | $359 | $359 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $528 | $528 | $528 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $260 | $260 | $260 |
| 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 | $173 | $173 | $173 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $375 | $375 | $375 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $390 | $390 | $390 |