Negotiated reimbursement rates for D6242 across 48 states, sourced from CMS Transparency in Coverage data. 709 rate records.
D6242 describes a bridge pontic constructed from porcelain fused to noble metal. This procedure is indicated for patients needing a durable and aesthetic solution for missing teeth. Documentation should include the specific tooth number, the type of materials used, and any relevant clinical notes. Reimbursement for D6242 can vary widely among payors and states, with some insurance plans offering better coverage for noble metal restorations compared to base metal. The average reimbursement for this procedure is approximately $766, but actual payments may depend on the patient's insurance policy and any applicable deductibles or co-pays.
Reimbursement rates for D6242 vary significantly by state, payor, and provider network. The national average negotiated rate is $766. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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