| Item Number | Description | Schedule Fee |
|---|---|---|
| 51033 | Spine, posterior and/or posterolateral bone graft to, 3 motion segments, not being a service associated with a service to which item 51031, 51032, 51034, 51035 or 51036 applies (Anaes.) (Assist.) |
$1,537.65 |
| Total: | $1,537.65 | |