| Item Number | Description | Schedule Fee |
|---|---|---|
| 45609 | Mandible, maxilla or skull base, reconstruction of, using bony free flap, all osteotomies, shaping, inset and fixation by any means, including all necessary 3 dimensional planning, if performed in conjunction with one or more services covered by items 46060 to 46068 (H) (Anaes.) (Assist.) |
$965.10 |
| Total: | $965.10 | |