21076

CPT/HCPCS

Preparation of temporary prosthesis to close an opening in mouth

Physician Fee Schedule

Facility

Medicare Payment

$501.86

Submitted Charge$4,249.48
Medicare Allowed$638.29
Providers35
Beneficiaries73
Total Services76
Office

Medicare Payment

$681.58

Submitted Charge$3,169.78
Medicare Allowed$862.14
Providers37
Beneficiaries91
Total Services94