Child Prophylaxis (D1120) — National Rates

Negotiated reimbursement rates for D1120 across 39 states, sourced from CMS Transparency in Coverage data. 386 rate records.

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National Average Negotiated Rate
$74
386 rate records · 39 states
📊 Data updated monthly · Last refresh: March 2026

About D1120 — Child Prophylaxis

D1120 is the code for child prophylaxis, which is a preventive dental cleaning specifically for pediatric patients. This procedure is designed to remove plaque and calculus from the teeth of children, helping to prevent cavities and promote good oral hygiene habits. Clinical indications for D1120 include routine cleanings for children with healthy teeth and gums or those at risk for dental caries. Documentation should include the child's dental history, any findings from the examination, and the cleaning performed. Reimbursement for D1120 can vary by payor and state, with many insurance plans covering this procedure as part of preventive services for children. It's essential to check the specific coverage policies of each payor to ensure accurate billing and maximize reimbursement.

Reimbursement rates for D1120 vary significantly by state, payor, and provider network. The national average negotiated rate is $74. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D1120

North Dakota
$74
1 records
Oregon
$69
3 records
New York
$69
6 records

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Full National Breakdown

Median
$66
Low
$22
High
$723

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
North Dakota$74
Oregon$69
New York$69
Nevada$67
Washington$63

↓ Bottom 5

StateAvg Rate
Iowa$22
Idaho$22
Kansas$22
Missouri$22
Tennessee$22

All States — D1120 Average Rates

North Dakota
$74
Oregon
$69
New York
$69
Nevada
$67
Washington
$63
Arizona
$61
New Jersey
$54
California
$50
Louisiana
$50
Georgia
$49
Texas
$48
Wisconsin
$47
South Carolina
$46
New Mexico
$46
Florida
$44
Puerto Rico
$44
Maryland
$40
Colorado
$39
Indiana
$38
Pennsylvania
$36
Connecticut
$36
Delaware
$36
Michigan
$35
Rhode Island
$34
Nebraska
$33
Kentucky
$32
Ohio
$32
Massachusetts
$31
Oklahoma
$31
Illinois
$31
North Carolina
$30
West Virginia
$30
Wyoming
$28
Minnesota
$26
Iowa
$22
Idaho
$22
Kansas
$22
Missouri
$22
Tennessee
$22
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
North Dakota$74$74$74$741
Oregon$69$69$69$693
New York$69$61$34$1106
Nevada$67$64$54$7912
Washington$63$67$58$675
Arizona$61$59$59$759
New Jersey$54$56$38$636
California$50$53$22$7220
Louisiana$50$50$50$501
Georgia$49$48$48$5811
Texas$48$58$22$643
Wisconsin$47$47$47$483
South Carolina$46$42$26$8820
New Mexico$46$46$46$461
Florida$44$44$30$7213
Puerto Rico$44$44$44$442
Maryland$40$35$35$554
Colorado$39$39$39$3910
Indiana$38$33$33$517
Pennsylvania$36$36$36$377
Connecticut$36$36$36$361
Delaware$36$36$36$361
Michigan$35$33$33$403
Rhode Island$34$34$34$348
Nebraska$33$29$23$668
Kentucky$32$32$32$321
Ohio$32$30$22$443
Massachusetts$31$34$22$344
Oklahoma$31$31$31$311
Illinois$31$34$22$363
North Carolina$30$30$30$302
West Virginia$30$30$30$301
Wyoming$28$28$28$281
Minnesota$26$26$25$262
Iowa$22$22$22$2210
Idaho$22$22$22$221
Kansas$22$22$22$221
Missouri$22$22$22$222
Tennessee$22$22$22$221
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