00170

CPT/HCPCS

Anesthesia for other procedure on mouth

Physician Fee Schedule

Facility

Medicare Payment

$113.54

Submitted Charge$1,480.61
Medicare Allowed$148.69
Providers19,328
Beneficiaries24,040
Total Services35,104
Office

Medicare Payment

$95.00

Submitted Charge$1,104.87
Medicare Allowed$135.81
Providers485
Beneficiaries832
Total Services1,186