70555

CPT/HCPCS

Functional mri scan of brain with neurofunctional testing

Physician Fee Schedule

Facility

Medicare Payment

$94.31

Submitted Charge$779.93
Medicare Allowed$121.67
Providers118
Beneficiaries263
Total Services269
Office

Medicare Payment

$366.61

Submitted Charge$3,490.99
Medicare Allowed$464.44
Providers23
Beneficiaries37
Total Services38