Negotiated reimbursement rates for D2644 across 48 states, sourced from CMS Transparency in Coverage data. 586 rate records.
D2644 is the CDT code for a porcelain or ceramic onlay that covers four or more surfaces of a tooth. This procedure is indicated for teeth with extensive decay or structural compromise, where a traditional filling would not provide adequate support. Documentation for this procedure should include detailed clinical notes, radiographs, and a rationale for the choice of an onlay over other restorative options. When billing for D2644, it is crucial to check the specific guidelines of the patient's insurance plan, as reimbursement can vary widely by payor and state. Some insurance companies may have limitations on coverage for onlays, particularly if they are deemed cosmetic. The average reimbursement for this procedure is approximately $795, but dental billing professionals should be prepared for potential discrepancies based on individual plan benefits and local regulations.
Reimbursement rates for D2644 vary significantly by state, payor, and provider network. The national average negotiated rate is $795. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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