42107
CPT/HCPCSRemoval of growth of roof of mouth with local tissue graft
Physician Fee Schedule
Facility
Medicare Payment
$446.52
Submitted Charge$2,584.99
Medicare Allowed$562.45
Providers57
Beneficiaries56
Total Services63
Office
Medicare Payment
$387.79
Submitted Charge$682.89
Medicare Allowed$486.72
Providers15
Beneficiaries58
Total Services76