Negotiated reimbursement rates for D1558 across 27 states, sourced from CMS Transparency in Coverage data. 124 rate records.
D1558 involves the removal of a fixed space maintainer that is bilateral and located in the mandibular arch. This procedure is clinically indicated when the space maintainer is no longer necessary due to the eruption of permanent teeth or other dental treatments. Documentation should include the rationale for removal, the condition of the space maintainer, and any relevant clinical observations. Average reimbursement for this procedure is approximately $50, but this can vary widely depending on the insurance provider and state regulations. Some payors may have specific criteria for coverage, and dental billing professionals should ensure that all necessary documentation is submitted to avoid claim denials.
Reimbursement rates for D1558 vary significantly by state, payor, and provider network. The national average negotiated rate is $50. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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