42335

CPT/HCPCS

Complicated removal of saliva gland stone from inside mouth

Physician Fee Schedule

Facility

Medicare Payment

$166.33

Submitted Charge$1,353.36
Medicare Allowed$209.20
Providers200
Beneficiaries236
Total Services256
Office

Medicare Payment

$308.87

Submitted Charge$1,164.58
Medicare Allowed$399.25
Providers108
Beneficiaries114
Total Services114