Unspecified Maxillofacial Prosthetic Procedure (D5999) — National Rates

Negotiated reimbursement rates for D5999 across 2 states, sourced from CMS Transparency in Coverage data. 9 rate records.

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National Average Negotiated Rate
$7,384
9 rate records · 2 states
📊 Data updated monthly · Last refresh: March 2026

About D5999 — Unspecified Maxillofacial Prosthetic Procedure

D5999 refers to an unspecified maxillofacial prosthetic procedure, which encompasses a range of treatments aimed at restoring facial structures lost due to trauma, disease, or congenital defects. Clinical indications for this code may include the need for prosthetic rehabilitation in patients with significant maxillofacial defects. Documentation should include detailed clinical notes, photographs, and treatment plans to justify the procedure. Reimbursement for D5999 can vary widely by payor and state, as some insurance plans may not cover unspecified procedures, while others may provide partial reimbursement based on the complexity of the case.

Reimbursement rates for D5999 vary significantly by state, payor, and provider network. The national average negotiated rate is $7. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D5999

New York
$8,295
6 records
Pennsylvania
$8,295
1 records

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Full National Breakdown

Median
$8,295
Low
$100
High
$8,295

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
New York$8,295
Pennsylvania$8,295

↓ Bottom 5

StateAvg Rate
New York$8,295
Pennsylvania$8,295

All States — D5999 Average Rates

New York
$8,295
Pennsylvania
$8,295
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
New York$8,295$8,295$8,295$8,2956
Pennsylvania$8,295$8,295$8,295$8,2951
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