42140

CPT/HCPCS

Removal of soft tissue of roof of mouth

Physician Fee Schedule

Facility

Medicare Payment

$250.46

Submitted Charge$1,706.28
Medicare Allowed$317.10
Providers237
Beneficiaries224
Total Services288
Office

Medicare Payment

$213.67

Submitted Charge$954.92
Medicare Allowed$285.09
Providers58
Beneficiaries67
Total Services67