21079

CPT/HCPCS

Impression and custom preparation of temporary oral prosthesis

Physician Fee Schedule

Facility

Medicare Payment

$896.55

Submitted Charge$7,323.15
Medicare Allowed$1,133.31
Providers31
Beneficiaries84
Total Services91
Office

Medicare Payment

$1,128.94

Submitted Charge$2,546.77
Medicare Allowed$1,422.48
Providers101
Beneficiaries665
Total Services766