| Item Number | Description | Schedule Fee |
|---|---|---|
| 49215 | Reconstruction of single or multiple ligaments or capsules of wrist, including any of the following (if performed): (a) arthrotomy; (b) ligament harvesting and grafting; (c) synovectomy; (d) tendon harvesting and grafting; (e) insertion of synthetic ligament substitute (H) (Anaes.) (Assist.) |
$757.95 |
| Total: | $757.95 | |