42631 Per Site
| 40000 | PERIODONTICS |
||
| 42000 | PERIODONTAL SERVICES, SURGICAL |
||
| 42600 | PERIODONTAL SURGERY, FLAPS, GRAFTS, OSSEOUS TISSUE |
||
| 42630 | Grafts, Osseous, Xenograft (Including Flap Entry and Closure) |
||
| 42631 | Per Site |
$1111.75
+Material Expenses |
$1111.75
+Mater. Exp. |