42330

CPT/HCPCS

Uncomplicated removal of saliva gland stone from inside mouth

Physician Fee Schedule

Facility

Medicare Payment

$109.73

Submitted Charge$1,146.74
Medicare Allowed$139.66
Providers193
Beneficiaries196
Total Services214
Office

Medicare Payment

$169.38

Submitted Charge$644.27
Medicare Allowed$227.64
Providers429
Beneficiaries464
Total Services471