Negotiated reimbursement rates for D5421 across 35 states, sourced from CMS Transparency in Coverage data. 167 rate records.
D5421 is the code used for adjusting a partial upper denture. This procedure is necessary when a patient experiences discomfort or issues with the fit of their partial denture. Clinical indications for this adjustment include sore spots, instability, or difficulty in chewing. Documentation should include the patient's reported issues, clinical findings, and details of the adjustments made. The average reimbursement for D5421 is approximately $57, but this can vary widely depending on the insurance plan and state regulations. Some payors may have specific limitations on the frequency of adjustments, so dental billing professionals must be aware of these factors to ensure accurate billing and maximize reimbursement.
Reimbursement rates for D5421 vary significantly by state, payor, and provider network. The national average negotiated rate is $57. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
32+ more states available with Pro ↓