| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $127 | $127 | $127 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $154 | $154 | $154 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $58 | $58 | $58 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $73 | $73 | $73 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $54 | $54 | $54 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $70 | $70 | $70 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $96 | $96 | $96 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $117 | $117 | $117 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $157 | $157 | $157 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $126 | $126 | $126 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $144 | $144 | $144 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $165 | $165 | $165 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $177 | $177 | $177 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $150 | $150 | $150 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $74 | $74 | $74 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $63 | $63 | $63 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $14 | $14 | $14 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $198 | $198 | $198 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $65 | $65 | $65 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $76 | $76 | $76 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $51 | $51 | $51 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $149 | $149 | $149 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $33 | $33 | $33 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $11 | $11 | $11 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $74 | $74 | $74 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $106 | $106 | $106 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $132 | $132 | $132 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $30 | $30 | $30 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $18 | $18 | $18 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $178 | $178 | $178 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $1,618 | $1,618 | $1,618 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $51 | $51 | $51 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $3,949 | $3,949 | $3,949 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $278 | $278 | $278 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,291 | $1,291 | $1,291 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $604 | $604 | $604 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $254 | $254 | $254 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $300 | $300 | $300 |
| Septoplasty CPT 30520 • ENT | $436 | $436 | $436 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $135 | $135 | $135 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $115 | $115 | $115 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $232 | $232 | $232 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $281 | $281 | $281 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $420 | $420 | $420 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $200 | $200 | $200 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $330 | $330 | $330 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $532 | $532 | $532 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $182 | $182 | $182 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $297 | $297 | $297 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $322 | $322 | $322 |