40830

CPT/HCPCS

Repair of lacerated mouth, 2.5 cm or less

Physician Fee Schedule

Facility

Medicare Payment

$93.54

Submitted Charge$770.08
Medicare Allowed$118.53
Providers77
Beneficiaries77
Total Services78
Office

Medicare Payment

$104.27

Submitted Charge$492.18
Medicare Allowed$131.14
Providers85
Beneficiaries520
Total Services758