| Item Number | Description | Schedule Fee |
|---|---|---|
| 49309 | Arthrectomy or excision arthroplasty (Girdlestone) of hip, other than a service performed: (a) for the purpose of implant removal; or (b) as stage 1 of a 2-stage procedure (H) (Anaes.) (Assist.) |
$878.70 |
| Total: | $878.70 | |