40899

CPT/HCPCS

Other procedure on inner mouth

Physician Fee Schedule

Facility

Medicare Payment

$265.66

Submitted Charge$3,213.59
Medicare Allowed$332.36
Providers24
Beneficiaries38
Total Services41
Office

Medicare Payment

$68.92

Submitted Charge$638.26
Medicare Allowed$86.49
Providers8
Beneficiaries69
Total Services69