21047
CPT/HCPCSRemoval of growth or cyst of part of lower jaw bone
Physician Fee Schedule
Facility
Medicare Payment
$745.01
Submitted Charge$4,537.13
Medicare Allowed$934.93
Providers155
Beneficiaries238
Total Services271
Office
Medicare Payment
$581.67
Submitted Charge$1,922.44
Medicare Allowed$734.75
Providers33
Beneficiaries78
Total Services89