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Placement of locating device in breast using ultrasound guidance, each additional growth

Placement of locating device in breast using MRI guidance, first growth

Removal of extra breast tissue in male

Repair for sagging of the breast

Removal of ruptured breast implant and implant material

Placement of implant on same day of breast reconstruction

Reconstruction of nipple or area around nipple

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

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

Full thickness skin graft to nose, ears, eyelids, or lips, each additional 20.0 sq cm