Negotiated reimbursement rates for D4231 across 49 states, sourced from CMS Transparency in Coverage data. 520 rate records.
D4231 is used for anatomical crown exposure involving one to three teeth, billed on a per quadrant basis. This procedure is similar to D4230 but is applicable when fewer teeth are involved. Clinical indications include the need for restorative work where the crown is not adequately exposed due to excess gum tissue or periodontal conditions. Documentation should include clinical notes, radiographs, and a justification for the procedure. Average reimbursement for D4231 is around $387, but this can differ by payor and state. Some insurance providers may have specific guidelines regarding coverage, necessitating a review of the patient's benefits prior to the procedure.
Reimbursement rates for D4231 vary significantly by state, payor, and provider network. The national average negotiated rate is $387. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
46+ more states available with Pro ↓