| Item Number | Description | Schedule Fee |
|---|---|---|
| 42755 | Any of the following:(a) removal of glaucoma drainage device incorporating an extraocular reservoir;(b) insertion or removal of intraluminal stent;(c) tying off of lumenOne eye (H) (Anaes.) (Assist.) |
$192.95 |
| Total: | $192.95 | |