| Item Number | Description | Schedule Fee |
|---|---|---|
| 51034 | Spine, posterior and/or posterolateral bone graft to, 4 to 7 motion segments, not being a service associated with a service to which item 51031, 51032, 51033, 51035 or 51036 applies (Anaes.) (Assist.) |
$1,647.40 |
| Total: | $1,647.40 | |