| Item Number | Description | Schedule Fee |
|---|---|---|
| 51031 | Spine, posterior and/or posterolateral bone graft to, one motion segment, not being a service associated with a service to which item 51032, 51033, 51034, 51035 or 51036 applies (Anaes.) (Assist.) |
$1,098.25 |
| Total: | $1,098.25 | |