15769

CPT/HCPCS

Self soft tissue graft

Physician Fee Schedule

Facility

Medicare Payment

$313.58

Submitted Charge$2,638.08
Medicare Allowed$393.32
Providers1,581
Beneficiaries4,285
Total Services4,989
Office

Medicare Payment

$345.38

Submitted Charge$1,054.00
Medicare Allowed$443.27
Providers98
Beneficiaries536
Total Services943