Negotiated reimbursement rates for D5283 across 47 states, sourced from CMS Transparency in Coverage data. 631 rate records.
D5283 describes a Removable Unilateral Partial Denture made of resin, suitable for patients requiring a lightweight and aesthetically pleasing option for a single-sided edentulous area. Clinical indications include the need for a temporary or less invasive solution for tooth replacement. Proper documentation should include a comprehensive treatment plan, clinical notes, and any necessary radiographs. The average reimbursement for this procedure is approximately $496, but this can vary significantly by payor and state. Some insurance plans may have specific guidelines regarding the materials used for dentures, impacting coverage. Dental billing professionals should ensure they understand the nuances of each payor's policies to maximize reimbursement.
Reimbursement rates for D5283 vary significantly by state, payor, and provider network. The national average negotiated rate is $496. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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