Negotiated reimbursement rates for D4261 across 49 states, sourced from CMS Transparency in Coverage data. 834 rate records.
D4261 refers to Osseous Surgery — 1–3 Teeth (Per Quad), a procedure aimed at treating periodontal disease through the surgical modification of the bone surrounding affected teeth. This procedure is indicated for patients with localized periodontal issues where only a few teeth are involved. Accurate documentation is crucial and should include the clinical findings, treatment rationale, and details of the surgical procedure performed. Reimbursement for D4261 varies by payor, with some plans offering better coverage for surgical interventions than others. The average reimbursement for this procedure is approximately $456, but dental billing professionals must check individual payor policies to ensure compliance and maximize reimbursement.
Reimbursement rates for D4261 vary significantly by state, payor, and provider network. The national average negotiated rate is $456. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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