J9281
CPT/HCPCSMitomycin pyelocalyceal instillation, 1 mg
Physician Fee Schedule
Facility
Medicare Payment
$227.22
Submitted Charge$496.13
Medicare Allowed$285.18
Providers33
Beneficiaries48
Total Services13,246
Office
Medicare Payment
$228.34
Submitted Charge$623.49
Medicare Allowed$286.59
Providers147
Beneficiaries153
Total Services59,801