| Item Number | Description | Schedule Fee |
|---|---|---|
| 41702 | Functional sinus surgery of the ostiomeatal unit, including ethmoid, unilateral, other than a service associated with a service to which item 41662, 41698, 41703, 41705, 41710 or 41764 applies on the same side (H) (Anaes.) (Assist.) |
$796.05 |
| Total: | $796.05 | |