| Item Number | Description | Schedule Fee |
|---|---|---|
| 63019 | MRI—scan of head (including MRA if performed) for the assessment of suitability for the treatment of medically refractory essential tremor with magnetic resonance imaging‑guided focused ultrasound Applicable once per patient per lifetime (R) (Contrast) (Anaes.) |
$452.05 |
| Total: | $452.05 | |