Negotiated reimbursement rates for D5850 across 42 states, sourced from CMS Transparency in Coverage data. 347 rate records.
D5850 is the CDT code for Tissue Conditioning (Upper), a procedure that involves the application of a soft, pliable material to the tissue surface of an upper denture to improve fit and comfort. This procedure is indicated for patients experiencing irritation or discomfort from their current denture. Documentation for billing should include the patient's symptoms, the materials used, and any adjustments made. Reimbursement for this service averages around $100 but can vary based on the patient's insurance plan and state regulations. Some payors may cover this procedure as part of a comprehensive treatment plan, while others may consider it a separate service.
Reimbursement rates for D5850 vary significantly by state, payor, and provider network. The national average negotiated rate is $100. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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