40842
CPT/HCPCSRepair to increase depth on side of mouth
Physician Fee Schedule
Facility
Medicare Payment
$346.95
Submitted Charge$2,949.97
Medicare Allowed$434.68
Providers41
Beneficiaries64
Total Services67
Office
Medicare Payment
$441.95
Submitted Charge$1,081.42
Medicare Allowed$559.41
Providers7
Beneficiaries39
Total Services47