41899

CPT/HCPCS

Other procedure on teeth and gums

Physician Fee Schedule

Facility

Medicare Payment

$80.06

Submitted Charge$843.76
Medicare Allowed$100.34
Providers175
Beneficiaries305
Total Services743
Office

Medicare Payment

$92.15

Submitted Charge$507.07
Medicare Allowed$116.50
Providers59
Beneficiaries81
Total Services187