| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $66 | $66 | $66 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $195 | $195 | $195 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $127 | $127 | $127 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $156 | $156 | $156 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $133 | $133 | $133 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $63 | $63 | $63 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $107 | $107 | $107 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $197 | $197 | $197 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $219 | $219 | $219 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $179 | $179 | $179 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $253 | $253 | $253 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $299 | $299 | $299 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $324 | $324 | $324 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $166 | $166 | $166 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $74 | $74 | $74 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $70 | $70 | $70 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $7 | $7 | $7 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $132 | $132 | $132 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $143 | $143 | $143 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $170 | $170 | $170 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $147 | $147 | $147 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $213 | $213 | $213 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $5 | $5 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $2 | $2 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $52 | $52 | $52 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $34 | $34 | $34 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $61 | $61 | $61 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $14 | $14 | $14 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $7 | $7 | $7 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $81 | $81 | $81 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $722 | $722 | $722 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $23 | $23 | $23 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $1,787 | $1,787 | $1,787 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $208 | $208 | $208 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $815 | $815 | $815 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $452 | $452 | $452 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $188 | $188 | $188 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $364 | $364 | $364 |
| Septoplasty CPT 30520 • ENT | $829 | $829 | $829 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $288 | $288 | $288 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $260 | $260 | $260 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $333 | $333 | $333 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $541 | $541 | $541 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $433 | $433 | $433 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $240 | $240 | $240 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $355 | $355 | $355 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $506 | $506 | $506 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $249 | $249 | $249 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $383 | $383 | $383 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $398 | $398 | $398 |