| Q4262 | Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure) | 510 | $960 | $494.5K |
| Q4253 | Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure) | 410 | $750 | $305.4K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 450 | $80 | $37K |
| 97610 | The provider uses a low–frequency ultrasound device to try to improve wound healing. | 60 | $310 | $18.1K |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 110 | $120 | $13.2K |
| 15271 | The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2. | 80 | $100 | $8.1K |
| 11042 | The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2. | 80 | $90 | $7.1K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 90 | $60 | $5.2K |
| 99204 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider… | 40 | $110 | $4.7K |
| 11000 | The provider uses surgical instruments to debride the dead tissue in skin for up to 10 percent of the body surface. | 120 | $40 | $4.4K |