Item No.LocationSizeDepthBenefit 85% ($)
30026Not face/neck≤ 7 cmSuperficial51.85
30029Not face/neck≤ 7 cmDeeper tissue89.25
30032Face/neck≤ 7 cmSuperficial81.80
30035Face/neck≤ 7 cmDeeper tissue116.60
30038Not face/neck> 7 cmSuperficial89.25
30042Not face/neck> 7 cmDeeper tissue184.00
30045Face/neck> 7 cmSuperficial116.60
30049Face/neck> 7 cmDeeper tissue184.00
30052Ear, eyelid, nose, lipAnyFull thickness251.90
30055AnyAnyWound dressing under GA/regional/IV sedation73.35