| Item Number | Description | Schedule Fee |
|---|---|---|
| 49319 | Bilateral total arthroplasty of hip, including minor bone grafting (if performed), other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) |
$2,701.00 |
| Total: | $2,701.00 | |