00904
CPT/HCPCSAnesthesia for extensive procedure on perineum
Physician Fee Schedule
Facility
Medicare Payment
$181.87
Submitted Charge$2,349.63
Medicare Allowed$230.74
Providers4,224
Beneficiaries2,753
Total Services4,700
Office
Medicare Payment
$150.98
Submitted Charge$1,660.34
Medicare Allowed$191.39
Providers31
Beneficiaries17
Total Services32