| Item Number | Description | Schedule Fee |
|---|---|---|
| 36633 | Nephroscopy, percutaneous, with incision of any one or more of renal pelvis, calyx or calyces or ureter and including antegrade insertion of ureteric stent, other than a service associated with a service to which item 36627, 36639 or 36645 applies (H) (Anaes.) (Assist.) |
$864.95 |
| Total: | $864.95 | |