G0455

CPT/HCPCS

Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen

Physician Fee Schedule

Facility

Medicare Payment

$55.27

Submitted Charge$431.91
Medicare Allowed$70.92
Providers401
Beneficiaries599
Total Services639
Office

Medicare Payment

$95.93

Submitted Charge$879.20
Medicare Allowed$120.21
Providers91
Beneficiaries125
Total Services128