74401 Autograft – per site – Maxilla or Mandible
| 70000 | ORAL MAXILLOFACIAL SURGERY |
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| 74000 | SURGICAL EXCISION (not in conjunction with tooth removal, including biopsy) |
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| 74400 | HARD TISSUE GRAFTS TO THE JAW |
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| 74401 | Autograft – per site – Maxilla or Mandible |
$726.75
+Material Expenses |
$726.75
+Mater. Exp. |