| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $179 | $179 | $179 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $85 | $85 | $85 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $50 | $50 | $50 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $173 | $173 | $173 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $57 | $57 | $57 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $165 | $165 | $165 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $117 | $117 | $117 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $219 | $219 | $219 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $243 | $243 | $243 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $148 | $148 | $148 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $282 | $282 | $282 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $328 | $328 | $328 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $353 | $353 | $353 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $180 | $180 | $180 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $158 | $158 | $158 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $93 | $93 | $93 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $9 | $9 | $9 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $140 | $140 | $140 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $159 | $159 | $159 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $187 | $187 | $187 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $165 | $165 | $165 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $232 | $232 | $232 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $9 | $9 | $9 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $4 | $4 | $4 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $63 | $63 | $63 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $65 | $65 | $65 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $87 | $87 | $87 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $22 | $22 | $22 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $9 | $9 | $9 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $112 | $112 | $112 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $967 | $967 | $967 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $31 | $31 | $31 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,551 | $2,551 | $2,551 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $384 | $384 | $384 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,161 | $1,161 | $1,161 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $629 | $629 | $629 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $311 | $311 | $311 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $406 | $406 | $406 |
| Septoplasty CPT 30520 • ENT | $926 | $926 | $926 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $206 | $206 | $206 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $275 | $275 | $275 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $228 | $228 | $228 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $602 | $602 | $602 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $468 | $468 | $468 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $260 | $260 | $260 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $382 | $382 | $382 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $546 | $546 | $546 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $194 | $194 | $194 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $415 | $415 | $415 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $433 | $433 | $433 |