Removal of Fixed Space Maintainer (Bilateral, Max) (D1557) — National Rates

Negotiated reimbursement rates for D1557 across 36 states, sourced from CMS Transparency in Coverage data. 166 rate records.

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National Average Negotiated Rate
$45
166 rate records · 36 states
📊 Data updated monthly · Last refresh: March 2026

About D1557 — Removal of Fixed Space Maintainer (Bilateral, Max)

D1557 refers to the removal of a fixed space maintainer that is bilateral and located in the maxillary arch. This procedure is typically indicated when the primary teeth have been lost prematurely, and the space maintainer is no longer needed, either due to the eruption of permanent teeth or other dental interventions. Proper documentation should include the reason for removal, any associated clinical findings, and the condition of the surrounding teeth. Reimbursement for this procedure can vary significantly by payor and state, with average payments around $45. Some insurance plans may require prior authorization or specific documentation to process the claim, while others may have set limits on the number of space maintainer removals covered within a given timeframe.

Reimbursement rates for D1557 vary significantly by state, payor, and provider network. The national average negotiated rate is $45. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D1557

Oregon
$75
1 records
Washington
$75
1 records
Michigan
$66
2 records

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Full National Breakdown

Median
$49
Low
$20
High
$79

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
Oregon$75
Washington$75
Michigan$66
Wisconsin$65
Arizona$59

↓ Bottom 5

StateAvg Rate
Wyoming$24
New Mexico$23
Iowa$20
Idaho$20
Missouri$20

All States — D1557 Average Rates

Oregon
$75
Washington
$75
Michigan
$66
Wisconsin
$65
Arizona
$59
Maine
$59
Connecticut
$58
Kentucky
$57
New Jersey
$57
Maryland
$56
District of Columbia
$56
Georgia
$55
South Carolina
$55
New York
$54
Indiana
$50
Florida
$50
Louisiana
$49
Texas
$47
Virginia
$47
Colorado
$46
Pennsylvania
$44
Illinois
$42
North Carolina
$41
Ohio
$38
Utah
$38
Massachusetts
$37
Kansas
$34
California
$32
Minnesota
$30
Arkansas
$25
Tennessee
$24
Wyoming
$24
New Mexico
$23
Iowa
$20
Idaho
$20
Missouri
$20
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
Oregon$75$75$75$751
Washington$75$75$75$751
Michigan$66$66$65$662
Wisconsin$65$65$65$651
Arizona$59$59$59$5913
Maine$59$59$59$591
Connecticut$58$58$54$632
Kentucky$57$64$23$646
New Jersey$57$62$27$705
Maryland$56$56$56$572
District of Columbia$56$56$56$561
Georgia$55$55$55$551
South Carolina$55$61$26$795
New York$54$53$23$7613
Indiana$50$50$50$501
Florida$50$49$42$6719
Louisiana$49$49$49$491
Texas$47$51$20$5913
Virginia$47$46$39$564
Colorado$46$46$46$461
Pennsylvania$44$29$28$763
Illinois$42$52$20$533
North Carolina$41$41$41$411
Ohio$38$35$20$603
Utah$38$38$38$381
Massachusetts$37$43$20$434
Kansas$34$23$20$593
California$32$32$20$4810
Minnesota$30$23$23$6517
Arkansas$25$25$25$251
Tennessee$24$26$20$264
Wyoming$24$24$24$241
New Mexico$23$23$23$231
Iowa$20$20$20$2010
Idaho$20$20$20$201
Missouri$20$20$20$202
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