Q4204
CPT/HCPCSXwrap, per square centimeter
Physician Fee Schedule
Facility
Medicare Payment
$1,102.67
Submitted Charge$1,418.44
Medicare Allowed$1,383.96
Providers13
Beneficiaries36
Total Services1,306
Office
Medicare Payment
$1,133.31
Submitted Charge$1,457.30
Medicare Allowed$1,422.60
Providers84
Beneficiaries332
Total Services21,388.2