Caries Preventive Medicament Application (D1355) — National Rates

Negotiated reimbursement rates for D1355 across 24 states, sourced from CMS Transparency in Coverage data. 172 rate records.

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National Average Negotiated Rate
$41
172 rate records · 24 states
📊 Data updated monthly · Last refresh: March 2026

About D1355 — Caries Preventive Medicament Application

D1355 is the code for Caries Preventive Medicament Application, which involves applying a medicament to prevent carious lesions. This procedure is clinically indicated for patients at high risk for caries, particularly children and those with special health care needs. Documentation should include the type of medicament used and the rationale for its application. Reimbursement for D1355 varies by payor, with some insurance plans covering it as a preventive service while others may have restrictions. The average reimbursement for this procedure is approximately $41.

Reimbursement rates for D1355 vary significantly by state, payor, and provider network. The national average negotiated rate is $41. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D1355

New Jersey
$72
4 records
New York
$69
19 records
Georgia
$64
2 records

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Full National Breakdown

Median
$36
Low
$16
High
$125

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
New Jersey$72
New York$69
Georgia$64
Connecticut$60
Virginia$45

↓ Bottom 5

StateAvg Rate
South Carolina$23
Kansas$22
Nevada$21
Arizona$18
Utah$16

All States — D1355 Average Rates

New Jersey
$72
New York
$69
Georgia
$64
Connecticut
$60
Virginia
$45
Oregon
$45
Florida
$45
Colorado
$42
Washington
$41
Illinois
$40
Kentucky
$40
California
$39
Indiana
$38
Michigan
$34
Ohio
$31
Wisconsin
$29
Missouri
$25
Texas
$25
Alabama
$23
South Carolina
$23
Kansas
$22
Nevada
$21
Arizona
$18
Utah
$16
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
New Jersey$72$71$71$734
New York$69$71$33$12519
Georgia$64$64$64$642
Connecticut$60$64$41$714
Virginia$45$45$45$452
Oregon$45$48$23$488
Florida$45$38$31$714
Colorado$42$42$42$421
Washington$41$42$31$484
Illinois$40$40$40$401
Kentucky$40$42$35$429
California$39$39$24$7542
Indiana$38$38$38$387
Michigan$34$34$31$372
Ohio$31$31$31$3233
Wisconsin$29$29$29$291
Missouri$25$23$22$4615
Texas$25$23$21$313
Alabama$23$23$23$231
South Carolina$23$23$23$232
Kansas$22$22$22$221
Nevada$21$21$21$211
Arizona$18$18$18$182
Utah$16$16$16$161
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