| Item Number | Description | Schedule Fee |
|---|---|---|
| 38847 | Pectus excavatum, repair of, with implantation of subcutaneous prosthesis, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38828, 38846, 38848 or 38849 applies (H) (Anaes.) (Assist.) |
$889.30 |
| Total: | $889.30 | |