42104
CPT/HCPCSRemoval of growth of roof of mouth
Physician Fee Schedule
Facility
Medicare Payment
$90.94
Submitted Charge$1,246.65
Medicare Allowed$117.58
Providers345
Beneficiaries326
Total Services400
Office
Medicare Payment
$156.72
Submitted Charge$574.29
Medicare Allowed$208.42
Providers627
Beneficiaries803
Total Services828