Repair Cast Partial Framework (Upper) (D5621) — National Rates

About D5621 — Repair Cast Partial Framework (Upper)

D5621 refers to the procedure of repairing a cast partial framework for the upper arch. This procedure is clinically indicated when a cast partial denture framework has sustained damage, which may include fractures or breaks that compromise its structural integrity. Proper documentation should include detailed notes on the extent of the damage, the materials used for the repair, and any necessary adjustments made during the procedure. Billing for this code may vary by payor and state, with some insurance plans covering the procedure at different rates based on their specific policies regarding prosthetic repairs. The average reimbursement for this procedure is approximately $131.

Reimbursement rates for D5621 vary significantly by state, payor, and provider network. The national average negotiated rate is $131. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.