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Removal of growth or cyst of jaw or upper cheek

Removal of growth or cyst of lower jaw bone

Impression and custom preparation of oral surgical splint

Reconstruction of upper jaw and midface bones

Repair of nasal or cheek bone with bone graft

Repair of lower jaw bone with bone graft

Obtaining ear cartilage for grafting

Drainage of deep abscess or blood accumulation in soft tissue of neck or chest

Removal of growth of soft tissue under skin of neck or front of chest, 3.0 cm or more

Removal of growth of muscle of neck or front of chest, 5.0 cm or more