00873
CPT/HCPCSAnesthesia for shock wave therapy for urinary system stones without water bath
Physician Fee Schedule
Facility
Medicare Payment
$110.58
Submitted Charge$1,405.60
Medicare Allowed$140.58
Providers17,232
Beneficiaries30,590
Total Services45,278
Office
Medicare Payment
$87.87
Submitted Charge$1,315.06
Medicare Allowed$111.97
Providers321
Beneficiaries349
Total Services594