40845

CPT/HCPCS

Complex repair to increase depth of mouth

Physician Fee Schedule

Facility

Medicare Payment

$586.53

Submitted Charge$4,481.55
Medicare Allowed$735.13
Providers153
Beneficiaries475
Total Services516
Office

Medicare Payment

$635.56

Submitted Charge$1,874.39
Medicare Allowed$798.25
Providers10
Beneficiaries75
Total Services105