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Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm

Repair of wound by transferring skin, each additional 30.0 sq cm

Partial thickness self skin graft to trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less

Full thickness skin graft to scalp, arms, or legs, 20.0 sq cm or less

Full thickness skin graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 20.0 sq cm or less

Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 25.0 sq cm of wound 100.0 sq cm or less

Transfer of skin flap to eyelids, nose, ears, or lips

Creation of flap graft to head and/or neck

Creation of skin and tissue graft