| Item Number | Description | Schedule Fee |
|---|---|---|
| 50632 | Scoliosis or kyphosis, in a child or adolescent, requiring segmental instrumentation and fusion of the spine down to and including the pelvis or sacrum, other than a service to which any of items 51011 to 51171 apply (H) (Anaes.) (Assist.) |
$4,151.50 |
| Total: | $4,151.50 | |