21048
CPT/HCPCSRemoval of growth or cyst of upper jaw bone through mouth
Physician Fee Schedule
Facility
Medicare Payment
$753.21
Submitted Charge$3,443.77
Medicare Allowed$949.28
Providers91
Beneficiaries159
Total Services175
Office
Medicare Payment
$516.66
Submitted Charge$1,814.73
Medicare Allowed$650.83
Providers109
Beneficiaries488
Total Services609