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Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 12.6-20.0 cm

Repair of separation of wound closure with Insertion of packing

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 20.1-30.0 cm

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, more than 30.0 cm

Intermediate repair of wound of neck, hands, feet, or genitals, 12.6-20.0 cm

Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm

Complicated repair of wound of eyelids, nose, ears, or lip, each additional 5.0 cm or less

Preparation of skin graft site of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less

Preparation of skin graft site of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less

Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less