| Item Number | Description | Schedule Fee |
|---|---|---|
| 48254 | Harvesting and insertion of pedicled bone flap (autograft), including internal fixation of the bone flap (if performed), other than a service associated with a service to which item 45562, 45504 or 45505 applies (H) (Anaes.) (Assist.) |
$1,065.35 |
| Total: | $1,065.35 | |