42630 Grafts, Osseous, Xenograft (Including Flap Entry and Closure)
| 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. |