Negotiated reimbursement rates for D4230 across 48 states, sourced from CMS Transparency in Coverage data. 786 rate records.
D4230 is the CDT code for anatomical crown exposure involving four or more teeth, billed on a per quadrant basis. This procedure is typically indicated when there is a need to expose the crown of the tooth for restorative purposes, often due to excessive gingival tissue or other periodontal issues. Documentation should include a thorough clinical examination, radiographs, and a treatment plan outlining the necessity for the procedure. Average reimbursement for D4230 is approximately $622, but this can vary widely based on the patient's insurance plan and state regulations. Some payors may require prior authorization or specific documentation to justify the procedure, so it is crucial to check coverage details beforehand.
Reimbursement rates for D4230 vary significantly by state, payor, and provider network. The national average negotiated rate is $622. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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