| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $144 | $144 | $144 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $65 | $65 | $65 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $116 | $116 | $116 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $140 | $140 | $140 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $44 | $44 | $44 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $134 | $134 | $134 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $147 | $147 | $147 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $180 | $180 | $180 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $197 | $197 | $197 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $165 | $165 | $165 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $140 | $140 | $140 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $263 | $263 | $263 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $185 | $185 | $185 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $233 | $233 | $233 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $62 | $62 | $62 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $77 | $77 | $77 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $8 | $8 | $8 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $194 | $194 | $194 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $77 | $77 | $77 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $94 | $94 | $94 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $111 | $111 | $111 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $149 | $149 | $149 |
| 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 | $40 | $40 | $40 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $29 | $29 | $29 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $38 | $38 | $38 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $10 | $10 | $10 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $4 | $4 | $4 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $50 | $50 | $50 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $440 | $440 | $440 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $15 | $15 | $15 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $166 | $166 | $166 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $160 | $160 | $160 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $419 | $419 | $419 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $348 | $348 | $348 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $145 | $145 | $145 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $343 | $343 | $343 |
| Septoplasty CPT 30520 • ENT | $785 | $785 | $785 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $252 | $252 | $252 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $217 | $217 | $217 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $184 | $184 | $184 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $507 | $507 | $507 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $374 | $374 | $374 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $208 | $208 | $208 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $306 | $306 | $306 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $436 | $436 | $436 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $520 | $520 | $520 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $789 | $789 | $789 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $826 | $826 | $826 |