| Item Number | Description | Schedule Fee |
|---|---|---|
| 50245 | Revision of reconstructive procedure, if item 50215, 50218 or 50224, or an item that describes a service substantially similar to any of those items, applied to the initial procedure, by any technique or combination of techniques (H) (Anaes.) (Assist.) |
$2,965.45 |
| Total: | $2,965.45 | |