42500

CPT/HCPCS

Simple repair of salivary duct

Physician Fee Schedule

Facility

Medicare Payment

$436.14

Submitted Charge$2,154.91
Medicare Allowed$548.75
Providers172
Beneficiaries183
Total Services217
Office

Medicare Payment

$347.24

Submitted Charge$1,360.86
Medicare Allowed$448.47
Providers42
Beneficiaries47
Total Services47