| Item Number | Description | Schedule Fee |
|---|---|---|
| 35697 | Microsurgical or laparoscopic tuboplasty (salpingostomy, salpingolysis or tubal implantation into uterus), UNILATERAL or BILATERAL, 1 or more procedures (Anaes.) (Assist.) |
$1,103.80 |
| Total: | $1,103.80 | |