Negotiated reimbursement rates for D3421 across 47 states, sourced from CMS Transparency in Coverage data. 682 rate records.
The CDT code D3421 refers to an apicoectomy procedure performed on a premolar, specifically addressing the first root. This surgical intervention is indicated when there is persistent infection or inflammation at the root tip that cannot be resolved through conventional root canal therapy. Proper documentation should include pre-operative radiographs, a detailed treatment plan, and post-operative follow-up notes. Reimbursement for this procedure can vary significantly depending on the payor and state, with average reimbursements around $634. Some insurance plans may have specific criteria for coverage, requiring prior authorization or documentation of failed root canal therapy before approving payment.
Reimbursement rates for D3421 vary significantly by state, payor, and provider network. The national average negotiated rate is $634. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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