0499T

CPT/HCPCS

Cysto f/urtl strix/stenosis

Physician Fee Schedule

Facility

Medicare Payment

$129.72

Submitted Charge$1,698.31
Medicare Allowed$162.89
Providers150
Beneficiaries375
Total Services380
Office

Medicare Payment

$136.74

Submitted Charge$1,209.50
Medicare Allowed$171.46
Providers5
Beneficiaries12
Total Services12