21081

CPT/HCPCS

Impression and custom preparation of lower jaw bone prosthesis

Physician Fee Schedule

Facility

Medicare Payment

$931.95

Submitted Charge$7,200.64
Medicare Allowed$1,175.17
Providers21
Beneficiaries86
Total Services87
Office

Medicare Payment

$1,248.16

Submitted Charge$4,463.14
Medicare Allowed$1,575.92
Providers62
Beneficiaries308
Total Services328