40840

CPT/HCPCS

Repair to increase depth of front portion of mouth

Physician Fee Schedule

Facility

Medicare Payment

$303.12

Submitted Charge$3,218.35
Medicare Allowed$381.25
Providers79
Beneficiaries148
Total Services163
Office

Medicare Payment

$492.49

Submitted Charge$1,520.09
Medicare Allowed$618.01
Providers10
Beneficiaries13
Total Services13