| Item Number | Description | Schedule Fee |
|---|---|---|
| 45200 | Single stage local flap, if indicated to repair one defect, simple and small, excluding flap for male pattern baldness and excluding H-flap or double advancement flap not in association with any of items 31356 to 31383 (Anaes.) |
$331.70 |
| Total: | $331.70 | |