| Item Number | Description | Schedule Fee |
|---|---|---|
| 49590 | Excision of ganglion, cyst or bursa of knee, by open or arthroscopic means, performed as an independent procedure, other than a service associated with a service to which another item in this Group applies (H) (Anaes.) (Assist.) |
$433.40 |
| Total: | $433.40 | |