21400

CPT/HCPCS

Closed treatment of broken eye bone

Physician Fee Schedule

Facility

Medicare Payment

$103.28

Submitted Charge$1,935.63
Medicare Allowed$131.33
Providers56
Beneficiaries69
Total Services69
Office

Medicare Payment

$177.46

Submitted Charge$821.27
Medicare Allowed$222.59
Providers19
Beneficiaries30
Total Services30