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Commissioner Approved Fee Schedule - FY 2025-26 39 <br /> Last <br /> Department/Program Description Current Fee Revision <br /> Oral evaluation for a patient under 3 years of age and <br /> D0145 I counseling with primary caregiver $81.00 2025 <br /> D1352 Reapplication of sealant $44.00 2025 <br /> Office Visit-Minimum charge for dental visit(sliding fee) $40.00 2024 <br /> Removal of Impacted Tooth-Soft Tissue $358.00 2024 <br /> Removal of Impacted Tooth-Partially Bony $374.00 2024 <br /> CPT Code <br /> Personal Health 0001U RBC DNA HEA 35 AG 11 BLD GRP(UNC Lab) $655.20 2025 <br /> 0130U HERED COLON CA DO MRNA PNL(UNC Lab) $532.26 2025 <br /> 0131U HERED BRST CA RLTD DO PNL 13(UNC Lab) $646.10 2025 <br /> 0132U HERED OVA CA RLTD DO PNL 17(UNC Lab) $674.89 2025 <br /> 0133U HERED PRST8 CA RLTD DO 11(UNC Lab) $628.16 2025 <br /> 0134U HERED PAN CA MRNA PNL 18 GEN(UNC Lab) $681.03 2025 <br /> 0135U HERED GYN CA MRNA PNL 12 GEN(UNC Lab) $637.51 2025 <br /> 0138U BRCAI BRCA2 MRNA SEQ ALYS(UNC Lab) $426.18 2025 <br /> 0162U HERED COLON CA TRGT MRNA PNL(UNC Lab) $442.75 2025 <br /> 0209U CYTOG CONST ALYS INTERROG(UNC Lab) $716.31 2025 <br /> 0225U NF DESCRIPTION BEGIN DATE/COVERAGE EFFE $298.60 2025 <br /> Surrogate Viral Neutralization Test(Svm),Severe Acute <br /> 0226U Respiratory Syndrome Coronavirus 2(Sarscov-2) <br /> (Coronavirus Disease[Covid-19]),Elisa,Plasma,Serum <br /> (UNC Lab) $42.28 2025 <br /> 0230U AR FULL SEQUENCE ANALYSIS(UNC Lab) $274.23 2025 <br /> 0234U MECP2 FULL GENE ANALYSIS(UNC Lab) $480.36 2025 <br /> 0238U ONC INCH SYN GEN DNA SEQ ALY(UNC Lab) $532.26 2025 <br /> Infectious Disease(Viral Respiratory Tract Infection), <br /> 0240U Pathogen-Specific Rna,3 Targets(Severe Acute Respiratory <br /> Syndrome Coronavirus 2[Sars-Cov-2],Influenza A, <br /> Influenza B),Upper Respiratory Specimen,Each Pathogen <br /> Reported As Detected Or Not Detected(UNC Lab) $142.63 2025 <br /> Infectious Disease(Viral Respiratory Tract Infection), <br /> Pathogen-Specific Rna,4 Targets(Severe Acute Respiratory <br /> 0241U Syndrome Coronavirus 2[Sars-Cov-2],Influenza A, <br /> Influenza B,Respiratory Syncytial Virus[Rsv]),Upper <br /> Respiratory Specimen,Each Pathogen Reported As Detected <br /> Or Not Detected(UNC Lab) $142.63 2025 <br /> 10060 Drainage of Skin Abscess $117.00 2009 <br /> 10061 Drainage of Skin Abscess $200.00 2009 <br /> 10080 Drainage of Pilonidal Cyst $195.00 2009 <br /> 10120 Remove Foreign Body $133.00 2009 <br /> 10140 Drainage of Hematoma/Fluid $147.00 2009 <br /> 10160 Puncture Drainage of Lesion $94.00 2008 <br /> 11000 Debride Infected Skin $56.00 2009 <br /> 11055 Paring of corn/callus(1 lesion) $46.00 2009 <br /> 11104 Biopsy of Skin Lesion(UNC Lab) $102.54 2025 <br /> 11105 Biopsy of Skin Lesion-Additional(UNC Lab) $50.44 2025 <br /> 11200 Remove Skin Tags $89.00 2007 <br /> 11720 IDebride Nail 1-5 $33.00 2008 <br /> 11730 Avulsion of Nail Plate $97.00 2011 <br /> 11740 Drain Blood from Under Nail $56.00 2009 <br /> 11765 Excision of Nail Fold,Toe $92.37 2025 <br /> 11981 Insertion,non-biodegradable drug $250.00 2012 <br /> 11982 Removal,non-biodegradable drug $154.00 2009 <br /> 11983 Removal,with reinsertion,non-biodegradable drug $234.00 2009 <br /> 12001 Repair Superficial Wound(s)2.5cm or less $171.00 2008 <br /> 12002 IRepair Superficial Wound(s)2.6-7.5cm $184.00 2009 <br />