| Item Number | Description | Schedule Fee |
|---|---|---|
| 49527 | Minor revision of total or partial arthroplasty of knee, including either or both of the following: (a) exchange of polyethylene component (including uni); (b) insertion of patellar component; other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) |
$1,537.35 |
| Total: | $1,537.35 | |