Negotiated reimbursement rates for D1575 across 44 states, sourced from CMS Transparency in Coverage data. 507 rate records.
D1575 describes the placement of a distal shoe space maintainer, which is used to maintain space for a permanent tooth that is not yet erupted. This procedure is particularly indicated in cases where a primary molar has been lost prematurely, and the distal shoe helps guide the eruption of the permanent successor. Documentation should detail the clinical rationale for the distal shoe, the condition of the surrounding teeth, and any relevant radiographic findings. The average reimbursement for this procedure is around $235, but this amount can differ based on the payor's policies and the state in which the service is provided. Some insurance plans may have specific guidelines regarding the use of distal shoes, so it is essential to verify coverage before proceeding.
Reimbursement rates for D1575 vary significantly by state, payor, and provider network. The national average negotiated rate is $235. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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