| Item Number | Description | Schedule Fee |
|---|---|---|
| 30635 | Varicocele, surgical correction of, including microsurgical techniques, other than a service associated with a service to which item 30390, 30627, 30641, 30642 or 30644 applies—one procedure (Anaes.) (Assist.) |
$340.40 |
| Total: | $340.40 | |