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