| Item Number | Description | Schedule Fee |
|---|---|---|
| 30042 | SKIN AND SUBCUTANEOUS TISSUE OR MUCOUS MEMBRANE, REPAIR OF WOUND OF, other than wound closure at time of surgery, other than on face or neck, large (MORE THAN 7 CM LONG), involving deeper tissue, other than a service to which another item in Group T4 applies (Anaes.) |
$216.45 |
| Total: | $216.45 | |