42540 Grafts, Soft Tissue, Pedicle, With Free Graft Placed In Pedicle Donor Site
| 40000 | PERIODONTICS |
||
| 42000 | PERIODONTAL SERVICES, SURGICAL |
||
| 42500 | PERIODONTAL SURGERY, FLAPS, GRAFTS, SOFT TISSUE |
||
| 42540 | Grafts, Soft Tissue, Pedicle, With Free Graft Placed In Pedicle Donor Site | ||
| 42541 | Per site |
1217.66 | 1217.66 |