| Item Number | Description | Schedule Fee |
|---|---|---|
| 45012 | Single stage large muscle flap repair to one defect (pectoralis major, gastrocnemius, gracilis or similar large muscle), other than a service associated with a service to which any of items 45524 to 45542 apply (H) (Anaes.) (Assist.) |
$907.85 |
| Total: | $907.85 | |