| Q4262 | Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure) | 570 | $960 | $548.9K |
| J0875 | Injection, dalbavancin, 5 mg | 8,100 | $10 | $97.2K |
| 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… | 820 | $80 | $61.6K |
| 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. | 490 | $70 | $35.1K |
| 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… | 60 | $110 | $6.7K |
| 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. | 60 | $90 | $5.3K |
| 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… | 110 | $50 | $5.1K |
| 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… | 50 | $90 | $4.7K |
| 97610 | The provider uses a low–frequency ultrasound device to try to improve wound healing. | 20 | $260 | $4.4K |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 20 | $130 | $1.9K |