| Item Number | Description | Schedule Fee |
|---|---|---|
| 36652 | PYELOSCOPY, retrograde, of one collecting system, with or without any one or more of, cystoscopy, ureteric meatotomy, ureteric dilatation, not being a service associated with a service to which item 36803, 36812 or 36824 applies (Anaes.) (Assist.) |
$758.05 |
| Total: | $758.05 | |