fee schedule 2009 new - DE Medical Assistance Program

15002 WOUND PREP, TRK/ARM/LEG 5.83 1.00
15003 WOUND PREP, ADDL 100 CM 1.17 1.00
15004 WOUND PREP, F/N/HF/G 7.22 1.00
15005 WND PREP, F/N/HF/G, ADDL CM 2.35 1.00
15040 HARVEST CULTURED SKIN GRAFT 3.33 1.00
15050 SKIN PINCH GRAFT 11.00 1.00
15100 SKIN SPLT GRFT, TRNK/ARM/LEG 18.27 1.00
15101 SKIN SPLT GRFT T/A/L, ADD-ON 2.97 1.00
15110 EPIDRM AUTOGRFT TRNK/ARM/LEG 18.87 1.00
15111 EPIDRM AUTOGRFT T/A/L ADD-ON 2.81 1.00
15115 EPIDRM A-GRFT FACE/NCK/HF/G 19.39 1.00
15116 EPIDRM A-GRFT F/N/HF/G ADDL 3.82 1.00
15120 SKN SPLT A-GRFT FAC/NCK/HF/G 19.74 1.00
15121 SKN SPLT A-GRFT F/N/HF/G ADD 4.60 1.00
15130 DERM AUTOGRAFT, TRNK/ARM/LEG 14.34 1.00
15131 DERM AUTOGRAFT T/A/L ADD-ON 2.27 1.00
15135 DERM AUTOGRAFT FACE/NCK/HF/G 19.73 1.00
15136 DERM AUTOGRAFT, F/N/HF/G ADD 2.29 1.00
15150 CULT EPIDERM GRFT T/ARM/LEG 16.54 1.00
15151 CULT EPIDERM GRFT T/A/L ADDL 3.04 1.00
15152 CULT EPIDERM GRAFT T/A/L +% 3.80 1.00
15155 CULT EPIDERM GRAFT, F/N/HF/G 17.74 1.00
15156 CULT EPIDRM GRFT F/N/HFG ADD 4.20 1.00
15157 CULT EPIDERM GRFT F/N/HFG +% 4.58 1.00
15170 ACELL GRAFT TRUNK/ARMS/LEGS 9.02 1.00
15171 ACELL GRAFT T/ARM/LEG ADD-ON 2.28 1.00
15175 ACELLULAR GRAFT, F/N/HF/G 12.38 1.00
15176 ACELL GRAFT, F/N/HF/G ADD-ON 3.63 1.00
15200 SKIN FULL GRAFT, TRUNK 16.23 1.00
15201 SKIN FULL GRAFT TRUNK ADD-ON 2.05 1.00
15220 SKIN FULL GRAFT SCLP/ARM/LEG 15.48 1.00
15221 SKIN FULL GRAFT ADD-ON 1.88 1.00
15240 SKIN FULL GRFT FACE/GENIT/HF 19.50 1.00
15241 SKIN FULL GRAFT ADD-ON 2.95 1.00
15260 SKIN FULL GRAFT EEN & LIPS 21.04 1.00
15261 SKIN FULL GRAFT ADD-ON 3.72 1.00
15300 APPLY SKINALLOGRFT, T/ARM/LG 7.33 1.00
15301 APPLY SKNALLOGRFT T/A/L ADDL 1.50 1.00
15320 APPLY SKIN ALLOGRFT F/N/HF/G 8.39 1.00
15321 APLY SKNALLOGRFT F/N/HFG ADD 2.26 1.00
15330 APLY ACELL ALOGRFT T/ARM/LEG 6.66 1.00
15331 APLY ACELL GRFT T/A/L ADD-ON 1.52 1.00
15335 APPLY ACELL GRAFT, F/N/HF/G 7.28 1.00
15336 APLY ACELL GRFT F/N/HF/G ADD 2.17 1.00
15340 APPLY CULT SKIN SUBSTITUTE 6.87 1.00
15341 APPLY CULT SKIN SUB ADD-ON 0.73 1.00
15360 APPLY CULT DERM SUB, T/A/L 7.67 1.00
15361 APLY CULT DERM SUB T/A/L ADD 1.68 1.00
15365 APPLY CULT DERM SUB F/N/HF/G 7.82 1.00
15366 APPLY CULT DERM F/HF/G ADD 2.15 1.00