D7240
CPT/HCPCSRemoval of impacted tooth-completely bony
Physician Fee Schedule
Facility
Medicare Payment
$160.19
Submitted Charge$629.95
Medicare Allowed$207.08
Providers13
Beneficiaries15
Total Services21
Office
Medicare Payment
$123.11
Submitted Charge$652.13
Medicare Allowed$176.20
Providers14
Beneficiaries15
Total Services15