Rates› D5213

Upper Partial Denture — Cast Metal Framework (D5213) — National Rates

Negotiated reimbursement rates for D5213 across 48 states, sourced from CMS Transparency in Coverage data. 1006 rate records.

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National Average Negotiated Rate
$1,466
1006 rate records · 48 states
📊 Data updated monthly · Last refresh: March 2026

About D5213 — Upper Partial Denture — Cast Metal Framework

D5213 describes the creation of an upper partial denture with a cast metal framework. This type of denture is indicated for patients requiring a more durable and stable prosthesis, often preferred for its strength and longevity. Documentation for this procedure should include clinical notes detailing the patient's oral condition, the rationale for selecting a cast metal framework, and any relevant diagnostic imaging. Reimbursement for D5213 is not typically specified, as average reimbursements are often not reported; however, it is essential to check with individual payors for their specific coverage policies. Variations in reimbursement can occur based on the patient's insurance plan and geographic location, making it critical for billing professionals to verify coverage before treatment.

Reimbursement rates for D5213 vary significantly by state, payor, and provider network. The national average negotiated rate is $1. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D5213

Alaska
$1,610
1 records
New York
$1,596
27 records
Oregon
$1,403
12 records

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Full National Breakdown

Median
$1,140
Low
$83
High
$6,007

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
Alaska$1,610
New York$1,596
Oregon$1,403
California$1,382
Connecticut$1,286

↓ Bottom 5

StateAvg Rate
Kansas$853
Indiana$830
Rhode Island$830
Arkansas$819
Iowa$535

All States — D5213 Average Rates

Alaska
$1,610
New York
$1,596
Oregon
$1,403
California
$1,382
Connecticut
$1,286
Nevada
$1,277
Maine
$1,270
Wisconsin
$1,252
Washington
$1,247
Delaware
$1,234
Hawaii
$1,231
Virginia
$1,228
South Dakota
$1,176
North Dakota
$1,162
New Jersey
$1,145
Minnesota
$1,141
New Hampshire
$1,124
New Mexico
$1,111
Colorado
$1,106
Mississippi
$1,101
West Virginia
$1,089
Louisiana
$1,086
Texas
$1,080
Maryland
$1,066
Missouri
$1,037
Illinois
$1,034
Georgia
$1,030
South Carolina
$1,026
Utah
$1,025
Massachusetts
$1,024
Arizona
$1,020
Alabama
$992
Idaho
$973
Pennsylvania
$956
Florida
$953
Ohio
$938
Tennessee
$934
Montana
$928
North Carolina
$921
Michigan
$911
Oklahoma
$899
Kentucky
$865
Nebraska
$864
Kansas
$853
Indiana
$830
Rhode Island
$830
Arkansas
$819
Iowa
$535
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
Alaska$1,610$1,610$1,610$1,6101
New York$1,596$1,033$732$3,64027
Oregon$1,403$1,469$751$1,57712
California$1,382$1,446$680$1,98571
Connecticut$1,286$1,414$722$1,5914
Nevada$1,277$1,258$992$1,77714
Maine$1,270$1,265$1,250$1,3137
Wisconsin$1,252$1,209$885$1,4589
Washington$1,247$1,236$845$1,57712
Delaware$1,234$1,252$936$1,5153
Hawaii$1,231$1,231$885$1,5772
Virginia$1,228$1,288$801$1,42916
South Dakota$1,176$1,176$1,176$1,1763
North Dakota$1,162$1,021$680$1,9284
New Jersey$1,145$1,260$680$1,43619
Minnesota$1,141$850$609$1,67630
New Hampshire$1,124$1,138$712$1,5064
New Mexico$1,111$1,053$937$1,4307
Colorado$1,106$1,101$937$1,48612
Mississippi$1,101$1,101$1,006$1,1962
West Virginia$1,089$1,097$983$1,1873
Louisiana$1,086$1,016$1,016$1,2253
Texas$1,080$1,174$831$1,46530
Maryland$1,066$1,097$712$1,50017
Missouri$1,037$1,076$500$1,39536
Illinois$1,034$976$810$1,57716
Georgia$1,030$1,064$712$1,67641
South Carolina$1,026$882$545$1,79436
Utah$1,025$1,011$828$1,2406
Massachusetts$1,024$988$722$1,50611
Arizona$1,020$937$750$1,50619
Alabama$992$991$781$1,1596
Idaho$973$1,021$855$1,0927
Pennsylvania$956$842$676$3,64022
Florida$953$853$712$1,83241
Ohio$938$888$500$1,21250
Tennessee$934$807$680$1,6766
Montana$928$928$772$1,0842
North Carolina$921$885$712$1,30566
Michigan$911$854$712$1,35011
Oklahoma$899$750$750$1,3058
Kentucky$865$798$595$1,07815
Nebraska$864$864$776$9532
Kansas$853$751$723$1,0843
Indiana$830$788$788$1,0005
Rhode Island$830$810$810$9939
Arkansas$819$921$616$9213
Iowa$535$500$500$7477
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