HCPCS Range Skin Substitutes and Biologicals

• 1 Apligraf, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4101 )

• 2 Oasis wound matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4102 )

• 3 Oasis burn matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4103 )

• 4 Integra bilayer matrix wound dressing (bmwd), per square centimeter (add-on, list separately in addition to primary procedure) ( Q4104 )

• 5 Integra dermal regeneration template (drt) or integra omnigraft dermal regeneration matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4105 )

• 6 Graftjacket, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4107 )

• 7 Integra matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4108 )

• 8 Primatrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4110 )

• 9 Gammagraft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4111 )

• 10 Cymetra, injectable, 1cc ( Q4112 )

• 11 GRAFTJACKET XPRESS, injectable, 1cc ( Q4113 )

• 12 Integra flowable wound matrix, injectable, 1cc ( Q4114 )

• 13 Alloskin, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4115 )

• 14 Alloderm, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4116 )

• 15 Hyalomatrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4117 )

• 16 MatriStem micromatrix, 1 mg ( Q4118 )

• 17 Theraskin, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4121 )

• 18 Dermacell, dermacell awm or dermacell awm porous, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4122 )

• 19 Alloskin rt, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4123 )

• 20 Oasis ultra tri-layer wound matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4124 )

• 21 Arthroflex, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4125 )

• 22 Memoderm, dermaspan, tranzgraft or integuply, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4126 )

• 23 Talymed, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4127 )

• 24 Flex hd, or allopatch hd, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4128 )

• 25 Strattice tm, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4130 )

• 26 Hmatrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4134 )

• 27 Mediskin, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4135 )

• 28 Ez-derm, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4136 )

• 29 Amnioexcel, amnioexcel plus or biodexcel, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4137 )

• 30 Biodfence dryflex, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4138 )

• 31 AmnioMatrix or biodmatrix, injectable, 1 cc ( Q4139 )

• 32 Biodfence, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4140 )

• 33 Alloskin ac, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4141 )

• 34 Xcm biologic tissue matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4142 )

• 35 Repriza, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4143 )

• 36 EpiFix, injectable, 1 mg ( Q4145 )

• 37 Tensix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4146 )

• 38 Architect, architect px, or architect fx, extracellular matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4147 )

• 39 Excellagen, 0.1 cc ( Q4149 )

• 40 Allowrap ds or dry, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4150 )

• 41 Amnioband or guardian, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4151 )

• 42 Dermapure, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4152 )

• 43 Dermavest and plurivest, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4153 )

• 44 Biovance, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4154 )

• 45 NeoxFlo or clarixFlo, 1 mg ( Q4155 )

• 46 Revitalon, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4157 )

• 47 Affinity, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4159 )

• 48 Nushield, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4160 )

• 49 Bio-connekt wound matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4161 )

• 50 Helicoll, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4164 )

• 51 Keramatrix or kerasorb, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4165 )

• 52 Cytal, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4166 )

• 53 Truskin, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4167 )

• 54 Amnioband, 1 mg ( Q4168 )

• 55 Artacent wound, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4169 )

• 56 Cygnus, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4170 )

• 57 Interfyl, 1 mg ( Q4171 )

• 58 Palingen or palingen xplus, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4173 )

• 59 Palingen or promatrx, 0.36 mg per 0.25 cc ( Q4174 )

• 60 Miroderm, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4175 )

• 61 Neopatch or therion, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4176 )

• 62 Floweramnioflo, 0.1 cc ( Q4177 )

• 63 Floweramniopatch, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4178 )

• 64 Flowerderm, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4179 )

• 65 Revita, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4180 )

• 66 Amnio wound, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4181 )

• 67 Transcyte, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4182 )

• 68 Grafix core and grafixpl core, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4132 )

• 69 Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4133 )

• 70 Neox cord 1k, neox cord rt, or clarix cord 1k, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4148 )

• 71 Neox 100 or clarix 100, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4156 )

• 72 Kerecis omega3, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4158 )

• 73 WoundEx Flow, BioSkin Flow, 0.5 cc ( Q4162 )

• 74 Woundex, bioskin, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4163 )

• 75 Surgigraft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4183 )

• 76 Cellesta or cellesta duo, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4184 )

• 77 Cellesta flowable amnion (25 mg per cc); per 0.5 cc ( Q4185 )

• 78 Epifix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4186 )

• 79 Epicord, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4187 )

• 80 Amnioarmor, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4188 )

• 81 Artacent ac, 1 mg ( Q4189 )

• 82 Artacent ac, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4190 )

• 83 Restorigin, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4191 )

• 84 Restorigin, 1 cc ( Q4192 )

• 85 Coll-e-derm, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4193 )

• 86 Novachor, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4194 )

• 87 Puraply, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4195 )

• 88 Puraply am, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4196 )

• 89 Puraply xt, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4197 )

• 90 Genesis amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4198 )

• 91 Skin te, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4200 )

• 92 Matrion, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4201 )

• 93 Keroxx (2.5g/cc), 1cc ( Q4202 )

• 94 Derma-gide, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4203 )

• 95 Xwrap, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4204 )

• 96 Amnion bio or axobiomembrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4211 )

• 97 Novafix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4208 )

• 98 Surgraft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4209 )

• 99 Membrane graft or membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4205 )

• 100 Fluid flow or fluid GF, 1 cc ( Q4206 )

• 101 Bellacell hd or surederm, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4220 )

• 102 Axolotl ambient or axolotl cryo, 0.1 mg ( Q4215 )

• 103 Artacent cord, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4216 )

• 104 Progenamatrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4222 )

• 105 Allogen, per cc ( Q4212 )

• 106 Ascent, 0.5 mg ( Q4213 )

• 107 Cellesta cord, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4214 )

• 108 MyOwn skin, includes harvesting and preparation procedures, per square centimeter ( Q4226 )

• 109 Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4217 )

• 110 Surgicord, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4218 )

• 111 Surgigraft-dual, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4219 )

• 112 Amniowrap2, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4221 )

• 113 Amniocore, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4227 )

• 114 Cogenex amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4229 )

• 115 Cogenex flowable amnion, per 0.5 cc ( Q4230 )

• 116 Corplex, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4232 )

• 117 Surfactor or nudyn, per 0.5 cc ( Q4233 )

• 118 Xcellerate, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4234 )

• 119 Amniorepair or altiply, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4235 )

• 120 Carepatch, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4236 )

• 121 Cryo-cord, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4237 )

• 122 Derm-maxx, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4238 )

• 123 Amnio-maxx or amnio-maxx lite, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4239 )

• 124 Corecyte, for topical use only, per 0.5 cc ( Q4240 )

• 125 Polycyte, for topical use only, per 0.5 cc ( Q4241 )

• 126 Amniocyte plus, per 0.5 cc ( Q4242 )

• 127 Amniotext, per cc ( Q4245 )

• 128 Coretext or protext, per cc ( Q4246 )

• 129 Amniotext patch, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4247 )

• 130 Dermacyte amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4248 )

• 131 Amniply, for topical use only, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4249 )

• 132 Amnioamp-mp, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4250 )

• 133 Novafix dl, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4254 )

• 134 Reguard, for topical use only, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4255 )

• 135 Vim, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4251 )

• 136 Vendaje, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4252 )

• 137 Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4253 )

• 138 Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4199 )

• 139 Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure) ( Q4224 )

• 140 Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4225 )

• 141 Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4256 )

• 142 Relese, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4257 )

• 143 Enverse, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4258 )

• 144 Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4259 )

• 145 Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4260 )

• 146 Tag, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4261 )

• 147 Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4262 )

• 148 Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4263 )

• 149 Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4264 )

• 150 Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4265 )

• 151 Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4266 )

• 152 Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4267 )

• 153 Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4268 )

• 154 Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4269 )

• 155 Complete sl, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4270 )

• 156 Complete ft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4271 )

• 157 Esano a, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4272 )

• 158 Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4273 )

• 159 Esano ac, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4274 )

• 160 Esano aca, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4275 )

• 161 Orion, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4276 )

• 162 Epieffect, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4278 )

• 163 Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4280 )

• 164 Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4281 )

• 165 Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4282 )

• 166 Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4283 )

• 167 Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4284 )

• 168 Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4285 )

• 169 Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4286 )

• 170 Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4279 )

• 171 Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4287 )

• 172 Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4288 )

• 173 Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4289 )

• 174 Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4290 )

• 175 Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4291 )

• 176 Lamellas, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4292 )

• 177 Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4293 )

• 178 Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4294 )

• 179 Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4295 )

• 180 Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4296 )

• 181 Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4297 )

• 182 Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4298 )

• 183 Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4299 )

• 184 Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4300 )

• 185 Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4301 )

• 186 Complete aca, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4302 )

• 187 Complete aa, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4303 )

• 188 Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4304 )

• 189 American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4305 )

• 190 American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4306 )

• 191 American amnion, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4307 )

• 192 Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4308 )

• 193 Via matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4309 )

• 194 Procenta, per 100 mg ( Q4310 )

• 195 Acesso, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4311 )

• 196 Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4312 )

• 197 Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4313 )

• 198 Reeva ft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4314 )

• 199 Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4315 )

• 200 Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4316 )

• 201 Vitograft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4317 )

• 202 E-graft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4318 )

• 203 Sanograft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4319 )

• 204 Pellograft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4320 )

• 205 Renograft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4321 )

• 206 Caregraft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4322 )

• 207 Alloply, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4323 )

• 208 Amniotx, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4324 )

• 209 Acapatch, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4325 )

• 210 Woundplus, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4326 )

• 211 Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4327 )

• 212 Most, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4328 )

• 213 Singlay, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4329 )

• 214 Total, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4330 )

• 215 Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4331 )

• 216 Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4332 )

• 217 Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4333 )

• 218 Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4334 )

• 219 Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4335 )

• 220 Artacent c, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4336 )

• 221 Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4337 )

• 222 Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4338 )

• 223 Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4339 )

• 224 Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4340 )

• 225 Simplimax, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4341 )

• 226 Theramend, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4342 )

• 227 Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4343 )

• 228 Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4344 )

• 229 Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4345 )

• 230 Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4346 )

• 231 Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4347 )

• 232 Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4348 )

• 233 Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4349 )

• 234 Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4350 )

• 235 Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4351 )

• 236 Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4352 )

• 237 Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4353 )

• 238 Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4354 )

• 239 Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4355 )

• 240 Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4356 )

• 241 Xwrap plus, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4357 )

• 242 Xwrap dual, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4358 )

• 243 Choriply, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4359 )

• 244 Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4360 )

• 245 Epixpress, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4361 )

• 246 Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4362 )

• 247 Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4363 )

• 248 Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4364 )

• 249 Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4365 )

• 250 Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4366 )

• 251 Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4367 )

• 252 Amchothick, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4368 )

• 253 Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4369 )

• 254 Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4370 )

• 255 Neoguard, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4371 )

• 256 Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4372 )

• 257 Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4373 )

• 258 Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4375 )

• 259 Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4376 )

• 260 Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4377 )

• 261 Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4378 )

• 262 Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4379 )

• 263 Advograft one, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4380 )

• 264 Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4382 )

• 265 Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4383 )

• 266 Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4384 )

• 267 Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4385 )

• 268 Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4386 )

• 269 Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4387 )

• 270 Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4388 )

• 271 Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4389 )

• 272 Ascendion, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4390 )

• 273 Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4391 )

• 274 Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4392 )

• 275 Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4393 )

• 276 Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4394 )

• 277 Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4395 )

• 278 Natalin, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4396 )

• 279 Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4397 )

• 280 Summit ac, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4398 )

• 281 Summit fx, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4399 )

• 282 Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4400 )

• 283 Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4401 )

• 284 Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4402 )

• 285 Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4403 )

• 286 Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4404 )

• 287 Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4405 )

• 288 Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4406 )

• 289 Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4407 )

• 290 Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4408 )

• 291 Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4409 )

• 292 Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4410 )

• 293 Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4411 )

• 294 Choriofix, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4412 )

• 295 Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4413 )

• 296 Simplichor, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4414 )

• 297 Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4415 )

• 298 Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4416 )

• 299 Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4417 )

• 300 Nuform, per square centimeter (add-on, list separately in addition to primary procedure) ( Q4420 )

• 301 Pma skin substitute product, not otherwise specified (list in addition to primary procedure) ( Q4431 )

• 302 510(k) skin substitute product, not otherwise specified (list in addition to primary procedure) ( Q4432 )

• 303 361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure) ( Q4433 )