| Item Number | Description | Schedule Fee |
|---|---|---|
| 45551 | Breast prosthesis, removal of, with excision of at least half of the fibrous capsule, not with insertion of any prosthesis. The excised specimen must be sent for histopathology and the volume removed must be documented in the histopathology report (Anaes.) (Assist.) |
$517.65 |
| Total: | $517.65 | |