Negotiated reimbursement rates for D5933 across 1 states, sourced from CMS Transparency in Coverage data. 3 rate records.
D5933 refers to an obturator modification, which can be either surgical or definitive in nature. This code is used when an existing obturator requires significant alterations to improve fit or function due to changes in the patient's anatomy or condition. Documentation should include the specific modifications made, the clinical rationale, and any relevant patient history. Reimbursement for D5933 is typically higher than for other obturator codes due to the complexity involved, but it can vary greatly by payor and state, with some insurers requiring prior authorization or additional documentation to support the need for modifications.
Reimbursement rates for D5933 vary significantly by state, payor, and provider network. The national average negotiated rate is $159. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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