40818

CPT/HCPCS

Removal of mouth tissue for grafting

Physician Fee Schedule

Facility

Medicare Payment

$115.15

Submitted Charge$1,185.27
Medicare Allowed$144.32
Providers116
Beneficiaries149
Total Services173
Office

Medicare Payment

$209.74

Submitted Charge$702.65
Medicare Allowed$282.32
Providers16
Beneficiaries26
Total Services28