00172

CPT/HCPCS

Anesthesia for procedure on mouth to repair palate deformity

Physician Fee Schedule

Facility

Medicare Payment

$177.76

Submitted Charge$2,237.24
Medicare Allowed$224.49
Providers85
Beneficiaries57
Total Services85
Office

Medicare Payment

$173.73

Submitted Charge$1,354.77
Medicare Allowed$276.62
Providers1
Beneficiaries12
Total Services13