Special Stain (Not Part of Routine) (D0476) — National Rates

Negotiated reimbursement rates for D0476 across 3 states, sourced from CMS Transparency in Coverage data. 10 rate records.

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National Average Negotiated Rate
$59
10 rate records · 3 states
📊 Data updated monthly · Last refresh: March 2026

About D0476 — Special Stain (Not Part of Routine)

D0476 refers to a special stain procedure that is not part of routine staining protocols in dental pathology. This procedure is typically indicated when a specific staining technique is required to highlight certain cellular components or pathological features that standard stains do not adequately reveal. Documentation for billing should include the rationale for the special stain, details of the specimen, and any relevant clinical findings. Reimbursement for D0476 can vary significantly by payor and state, with some insurance plans covering the procedure fully while others may apply limitations or require prior authorization. The average reimbursement for this code is around $59, but dental billing professionals should verify coverage specifics with individual payors to ensure accurate claims submission and payment processing.

Reimbursement rates for D0476 vary significantly by state, payor, and provider network. The national average negotiated rate is $59. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D0476

South Carolina
$95
1 records
New York
$82
1 records
California
$36
5 records

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Full National Breakdown

Median
$37
Low
$30
High
$100

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
South Carolina$95
New York$82
California$36

↓ Bottom 5

StateAvg Rate
South Carolina$95
New York$82
California$36

All States — D0476 Average Rates

South Carolina
$95
New York
$82
California
$36
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
South Carolina$95$95$95$951
New York$82$82$82$821
California$36$37$30$375
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