| Item Number | Description | Schedule Fee |
|---|---|---|
| 49210 | Revision of total replacement arthroplasty of wrist or distal radioulnar joint, including any of the following (if performed): (a) ligament rebalancing; (b) removal of prosthesis; (c) tendon rebalancing (H) (Anaes.) (Assist.) |
$1,159.95 |
| Total: | $1,159.95 | |