00872
CPT/HCPCSAnesthesia for shock wave therapy for urinary system stones with water bath
Physician Fee Schedule
Facility
Medicare Payment
$125.85
Submitted Charge$1,531.98
Medicare Allowed$159.27
Providers496
Beneficiaries766
Total Services1,170
Office
Medicare Payment
$93.79
Submitted Charge$1,614.43
Medicare Allowed$117.72
Providers10
Beneficiaries12
Total Services23