| Item Number | Description | Schedule Fee |
|---|---|---|
| 56629 | Computed tomography—scan of upper limb and lower limb, left or right or both, any one region (other than knee), or more than one region (which may include knee) without intravenous contrast medium not being a service to which item 56620 applies (R) (Anaes.) |
$247.55 |
| Total: | $247.55 | |