| Item Number | Description | Schedule Fee |
|---|---|---|
| 42791 | Laser vitreolysis or corticolysis of lens material or fibrinolysis, excluding vitreolysis in the posterior vitreous cavity—each treatment to one eye, to a maximum of 3 treatments to that eye in a 2 year period (Anaes.) (Assist.) |
$412.25 |
| Total: | $412.25 | |