| Item Number | Description | Schedule Fee |
|---|---|---|
| 38754 | Intraventricular baffle or conduit, insertion of, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) |
$3,117.05 |
| Total: | $3,117.05 | |