21049
CPT/HCPCSRemoval of growth or cyst of part of upper jaw bone
Physician Fee Schedule
Facility
Medicare Payment
$606.86
Submitted Charge$3,297.10
Medicare Allowed$760.83
Providers26
Beneficiaries80
Total Services89
Office
Medicare Payment
$518.08
Submitted Charge$1,999.96
Medicare Allowed$650.69
Providers31
Beneficiaries120
Total Services130