Negotiated reimbursement rates for D5811 across 49 states, sourced from CMS Transparency in Coverage data. 725 rate records.
D5811 is the code for an interim complete lower denture, similar to D5810 but for the lower arch. This procedure is indicated for patients who require a temporary solution to replace missing lower teeth, allowing them to maintain function and aesthetics while awaiting a permanent denture. Proper documentation is crucial and should include the clinical rationale for the interim denture, patient history, and any relevant treatment notes. Reimbursement rates for D5811 can differ significantly among payors and states, with some plans offering comprehensive coverage while others may have restrictions. The average reimbursement for this procedure is approximately $497, so dental billing professionals should ensure they are familiar with the specific guidelines of the patient's insurance plan to optimize reimbursement.
Reimbursement rates for D5811 vary significantly by state, payor, and provider network. The national average negotiated rate is $497. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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