| Item Number | Description | Schedule Fee |
|---|---|---|
| 49392 | Revision arthroplasty of hip, including: (a) either: (i) revision of femoral component with femoral osteotomy; or (ii) proximal femoral replacement; and (b) revision of acetabular component for pelvic discontinuity (H) (Anaes.) (Assist.) |
$5,380.60 |
| Total: | $5,380.60 | |