fee schedule 2009 new - DE Medical Assistance Program

15340 3 APPLY CULT SKIN SUBSTITUTE 290.67
15341 3 APPLY CULT SKIN SUB ADD-ON 43.11
15342 O CULTURED SKIN GRAFT, 25 CM 0.00
15343 O CULTURE SKN GRAFT ADDL 25 CM 0.00
15350 O SKIN HOMOGRAFT 0.00
15351 O SKIN HOMOGRAFT ADD-ON 0.00
15360 3 APPLY CULT DERM SUB, T/A/L 329.30
15361 3 APLY CULT DERM SUB T/A/L ADD 64.28
15365 3 APPLY CULT DERM SUB F/N/HF/G 328.80
15366 3 APPLY CULT DERM F/HF/G ADD 81.07
15400 3 APPLY SKIN XENOGRAFT, T/A/L 339.59
15401 3 APPLY SKN XENOGRFT T/A/L ADD 95.08
15410 O FREE TRANSPLANTATION OF SKIN FLAP B 0.00
15412 O FREE TRANSPLANTATION OF SKIN FLAP B 0.00
15414 O FREE TRANSPLANTATION OF SKIN FLAP B 0.00
15416 O FREE TRANSPLANTATION OF SKIN FLAP B 0.00
15420 3 APPLY SKIN XGRAFT, F/N/HF/G 382.40
15421 3 APPLY SKN XGRFT F/N/HF/G ADD 105.83
15430 3 APPLY ACELLULAR XENOGRAFT 486.50
15431 6 APPLY ACELLULAR XGRAFT ADD 0.00
15500 O FORMATION OF TUBE PEDICLE WITHOUT T 0.00
15505 O FORMATION OF TUBE PEDICLE WITHOUT T 0.00
15510 O FORMATION OF TUBE PEDICLE WITHOUT T 0.00
15515 O FORMATION OF TUBE PEDICLE WITHOUT T 0.00
15540 O PRIMARY ATTACHMENT OF OPEN OR TUBED 0.00
15545 O PRIMARY ATTACHMENT OF OPEN OR TUBED 0.00
15550 O PRIMARY ATTACHMENT OF OPEN OR TUBED 0.00
15555 O PRIMARY ATTACHMENT OF OPEN OR TUBED 0.00
15570 3 FORM SKIN PEDICLE FLAP 799.87
15572 3 FORM SKIN PEDICLE FLAP 751.71
15574 3 FORM SKIN PEDICLE FLAP 809.91
15576 3 FORM SKIN PEDICLE FLAP 721.61
15580 O ATTACH SKIN PEDICLE GRAFT 0.00
15600 3 SKIN GRAFT 328.38
15610 3 SKIN GRAFT 295.75
15620 3 SKIN GRAFT 413.71
15625 O SKIN GRAFT 0.00
15630 3 SKIN GRAFT 421.83
15650 3 TRANSFER SKIN PEDICLE FLAP 453.59
15700 O EXCISION OF LESION AND/OR EXCISIONA 0.00
15710 O EXCISION OF LESION AND/OR EXCISIONA 0.00
15720 O EXCISION OF LESION AND/OR EXCISIONA 0.00
15730 O EXCISION OF LESION AND/OR EXCISIONA 0.00
15731 3 FOREHEAD FLAP W/VASC PEDICLE 984.70
15732 3 MUSCLE-SKIN GRAFT, HEAD/NECK 1,370.93
15734 3 MUSCLE-SKIN GRAFT, TRUNK 1,219.77
15736 3 MUSCLE-SKIN GRAFT, ARM 1,268.96
15738 3 MUSCLE-SKIN GRAFT, LEG 1,345.01
15740 3 ISLAND PEDICLE FLAP GRAFT 877.64
15750 3 NEUROVASCULAR PEDICLE GRAFT 825.80