Negotiated reimbursement rates for D0472 across 8 states, sourced from CMS Transparency in Coverage data. 49 rate records.
D0472 is the CDT code for the accession of tissue with a gross examination only. This procedure involves the collection and initial examination of tissue samples, often for diagnostic purposes. Clinical indications include biopsies or tissue samples taken during surgical procedures. Documentation should include details about the tissue type, the reason for the biopsy, and any findings from the gross examination. Reimbursement for this procedure averages around $75, but may differ based on the payor’s policies and the state regulations. Some payors may require additional documentation or may bundle this service with other procedures, impacting the final reimbursement.
Reimbursement rates for D0472 vary significantly by state, payor, and provider network. The national average negotiated rate is $75. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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