Negotiated reimbursement rates for D5282 across 47 states, sourced from CMS Transparency in Coverage data. 636 rate records.
D5282 refers to a Removable Unilateral Partial Denture made of metal, typically used for patients with a single-sided edentulous area. Clinical indications include the need for a durable and stable prosthesis that can withstand the forces of mastication. Documentation should include a thorough examination of the patient's oral condition, treatment planning notes, and any relevant imaging. Reimbursement for this procedure averages around $532, but it can vary based on the patient's insurance policy and the state in which the service is provided. Some payors may have limitations on coverage for unilateral dentures, so it is crucial for dental billing professionals to verify benefits and obtain prior authorization if necessary.
Reimbursement rates for D5282 vary significantly by state, payor, and provider network. The national average negotiated rate is $532. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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