| Item Number | Description | Schedule Fee |
|---|---|---|
| 45203 | Single stage local flap, if indicated to repair one defect, complicated or large, 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.) (Assist.) |
$473.65 |
| Total: | $473.65 | |