| Item Number | Description | Schedule Fee |
|---|---|---|
| 16003 | Intra-cavitary administration of a therapeutic dose of Yttrium 90 (not including preliminary paracentesis and other than a service to which item 35404, 35406 or 35408 applies or a service associated with selective internal radiation therapy) (Anaes.) |
$1,655.45 |
| Total: | $1,655.45 | |