Negotiated reimbursement rates for D4260 across 50 states, sourced from CMS Transparency in Coverage data. 633 rate records.
D4260 is the code for Osseous Surgery — 4+ Teeth (Per Quad), a surgical procedure that involves the recontouring of the bone to treat periodontal disease. This procedure is indicated when there is significant bone loss around multiple teeth, necessitating surgical intervention to restore periodontal health. Documentation should include a thorough periodontal examination, treatment planning notes, and a detailed surgical report. Reimbursement for D4260 can differ widely among payors, with some providing comprehensive coverage for surgical procedures while others may have specific criteria that must be met. The average reimbursement for this procedure is around $826, but dental billing professionals should be aware of the varying reimbursement rates and potential pre-authorization requirements based on the patient's insurance plan and state regulations.
Reimbursement rates for D4260 vary significantly by state, payor, and provider network. The national average negotiated rate is $826. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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