21082

CPT/HCPCS

Impression and custom preparation of prosthesis for roof of mouth enlargement

Physician Fee Schedule

Facility

Medicare Payment

$685.85

Submitted Charge$6,498.11
Medicare Allowed$862.08
Providers19
Beneficiaries49
Total Services51
Office

Medicare Payment

$1,147.28

Submitted Charge$3,221.04
Medicare Allowed$1,449.87
Providers40
Beneficiaries227
Total Services250