| Item Number | Description | Schedule Fee |
|---|---|---|
| 49521 | Complex primary arthroplasty of knee, using revision femoral or tibial components, including either or both of the following (if performed): (a) ligament reconstruction; (b) patellar resurfacing; other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) |
$1,867.20 |
| Total: | $1,867.20 | |