Negotiated reimbursement rates for D5228 across 46 states, sourced from CMS Transparency in Coverage data. 684 rate records.
D5228 describes an Immediate Lower Partial Denture with a flexible base, designed for patients needing immediate tooth replacement in the lower arch. This procedure is clinically indicated for those who have lost teeth and require prompt restoration to improve function and aesthetics. Documentation should include clinical notes, a treatment plan, and any relevant radiographs. Reimbursement for this procedure can vary widely depending on the patient's insurance plan and state regulations, with an average reimbursement of approximately $755. Dental billing professionals should be aware that some payors may have specific criteria for coverage, and it is essential to confirm these details prior to submitting claims.
Reimbursement rates for D5228 vary significantly by state, payor, and provider network. The national average negotiated rate is $755. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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