Negotiated reimbursement rates for D1353 across 19 states, sourced from CMS Transparency in Coverage data. 71 rate records.
D1353 is the code for Sealant Repair on a per-tooth basis, which is necessary when a previously placed sealant has worn or chipped and needs to be repaired to maintain its protective function. This procedure is clinically indicated when a sealant is compromised but the tooth remains at risk for caries. Proper documentation should include the reason for repair and the condition of the sealant. Reimbursement for D1353 varies by payor, with some plans covering it under preventive services while others may not. The average reimbursement is around $30.
Reimbursement rates for D1353 vary significantly by state, payor, and provider network. The national average negotiated rate is $30. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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