| Item Number | Description | Schedule Fee |
|---|---|---|
| 52131 | Bone graft with internal fixation, in the oral and maxillofacial region, other than a service to which another item in the range 51900 to 52186, or the range 52303 to 53460, applies (H) (Anaes.) (Assist.) |
$713.95 |
| Total: | $713.95 | |