40831

CPT/HCPCS

Repair of lacerated mouth, more than 2.5 cm

Physician Fee Schedule

Facility

Medicare Payment

$113.26

Submitted Charge$1,131.40
Medicare Allowed$141.88
Providers54
Beneficiaries57
Total Services60
Office

Medicare Payment

$131.90

Submitted Charge$499.90
Medicare Allowed$166.19
Providers32
Beneficiaries244
Total Services348