Distal Shoe Space Maintainer (D1575) — National Rates

Negotiated reimbursement rates for D1575 across 44 states, sourced from CMS Transparency in Coverage data. 507 rate records.

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National Average Negotiated Rate
$235
507 rate records · 44 states
📊 Data updated monthly · Last refresh: March 2026

About D1575 — Distal Shoe Space Maintainer

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.

Top Paying States for D1575

West Virginia
$406
1 records
Colorado
$306
19 records
Connecticut
$305
21 records

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Full National Breakdown

Median
$230
Low
$73
High
$406

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
West Virginia$406
Colorado$306
Connecticut$305
New Jersey$304
South Carolina$299

↓ Bottom 5

StateAvg Rate
Kansas$156
Arkansas$146
Nebraska$130
Minnesota$124
Iowa$105

All States — D1575 Average Rates

West Virginia
$406
Colorado
$306
Connecticut
$305
New Jersey
$304
South Carolina
$299
New York
$295
District of Columbia
$282
Maryland
$280
North Carolina
$270
New Mexico
$269
New Hampshire
$257
North Dakota
$251
Washington
$250
Louisiana
$250
Florida
$245
Virginia
$243
Arizona
$243
Wisconsin
$242
Oregon
$241
California
$239
Oklahoma
$234
Missouri
$231
Georgia
$230
Texas
$227
Ohio
$221
Nevada
$217
Pennsylvania
$217
Massachusetts
$216
Hawaii
$216
Alabama
$204
Michigan
$203
Mississippi
$202
Illinois
$200
Tennessee
$189
Kentucky
$176
Indiana
$175
Utah
$175
Rhode Island
$164
Idaho
$160
Kansas
$156
Arkansas
$146
Nebraska
$130
Minnesota
$124
Iowa
$105
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
West Virginia$406$406$406$4061
Colorado$306$333$195$33319
Connecticut$305$320$169$32021
New Jersey$304$296$162$40621
South Carolina$299$310$200$3906
New York$295$311$93$40019
District of Columbia$282$282$282$2821
Maryland$280$302$178$31912
North Carolina$270$276$200$3304
New Mexico$269$269$246$2922
New Hampshire$257$234$234$31015
North Dakota$251$258$156$3403
Washington$250$238$228$2984
Louisiana$250$250$250$2501
Florida$245$230$221$31270
Virginia$243$253$186$31310
Arizona$243$226$218$3336
Wisconsin$242$238$109$3588
Oregon$241$235$169$29810
California$239$237$93$35762
Oklahoma$234$234$234$2341
Missouri$231$228$93$28711
Georgia$230$240$140$26410
Texas$227$248$93$33318
Ohio$221$230$93$2889
Nevada$217$212$203$26910
Pennsylvania$217$169$146$40628
Massachusetts$216$234$93$2869
Hawaii$216$185$144$3203
Alabama$204$204$179$2294
Michigan$203$199$199$25716
Mississippi$202$207$179$2203
Illinois$200$199$93$29612
Tennessee$189$197$93$2704
Kentucky$176$177$93$2594
Indiana$175$174$159$20513
Utah$175$175$161$1892
Rhode Island$164$164$162$1672
Idaho$160$163$93$2046
Kansas$156$137$93$2636
Arkansas$146$146$128$1642
Nebraska$130$119$118$1523
Minnesota$124$109$109$16012
Iowa$105$93$93$28916
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