Provisional Bridge Pontic (D6253) — National Rates

Negotiated reimbursement rates for D6253 across 46 states, sourced from CMS Transparency in Coverage data. 1246 rate records.

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National Average Negotiated Rate
$228
1246 rate records · 46 states
📊 Data updated monthly · Last refresh: March 2026

About D6253 — Provisional Bridge Pontic

D6253 refers to a Provisional Bridge Pontic, which is a temporary solution used while a permanent bridge is being fabricated. This procedure is indicated for patients who require immediate restoration of function and aesthetics after tooth extraction or prior to the placement of a definitive prosthesis. Documentation should include the rationale for provisionalization, treatment notes, and any relevant radiographs. Average reimbursement for this code is around $228, but it can vary widely based on the payor and state. Some insurance plans may have specific guidelines for provisional restorations, affecting the reimbursement process. It is advisable to confirm coverage details with the payor prior to treatment.

Reimbursement rates for D6253 vary significantly by state, payor, and provider network. The national average negotiated rate is $228. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D6253

Minnesota
$420
4 records
Washington
$403
12 records
Alaska
$349
3 records

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Full National Breakdown

Median
$230
Low
$20
High
$945

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
Minnesota$420
Washington$403
Alaska$349
Oregon$339
Arizona$330

↓ Bottom 5

StateAvg Rate
Idaho$185
Nebraska$178
Iowa$170
Kansas$170
Wyoming$152

All States — D6253 Average Rates

Minnesota
$420
Washington
$403
Alaska
$349
Oregon
$339
Arizona
$330
Wisconsin
$329
Maine
$329
Oklahoma
$326
West Virginia
$326
Virginia
$320
Florida
$315
Delaware
$315
South Carolina
$303
Hawaii
$292
Tennessee
$284
Utah
$284
Georgia
$284
California
$277
Michigan
$273
Mississippi
$270
Colorado
$269
Texas
$265
South Dakota
$262
Pennsylvania
$261
Nevada
$258
Louisiana
$258
District of Columbia
$249
Kentucky
$245
New Mexico
$241
Massachusetts
$238
North Carolina
$238
Illinois
$236
New Hampshire
$226
Connecticut
$220
New Jersey
$219
North Dakota
$216
New York
$213
Ohio
$213
Indiana
$206
Missouri
$205
Maryland
$199
Idaho
$185
Nebraska
$178
Iowa
$170
Kansas
$170
Wyoming
$152
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
Minnesota$420$420$420$4204
Washington$403$428$267$45612
Alaska$349$360$259$4283
Oregon$339$370$193$4285
Arizona$330$348$131$37040
Wisconsin$329$323$323$35716
Maine$329$313$243$40112
Oklahoma$326$326$326$3261
West Virginia$326$326$316$3362
Virginia$320$349$192$39237
Florida$315$362$157$39247
Delaware$315$315$315$3151
South Carolina$303$272$170$45514
Hawaii$292$305$267$3053
Tennessee$284$267$267$39214
Utah$284$284$284$2842
Georgia$284$288$220$34116
California$277$282$150$48669
Michigan$273$301$177$42810
Mississippi$270$270$270$2701
Colorado$269$278$177$32410
Texas$265$268$198$34818
South Dakota$262$262$262$2621
Pennsylvania$261$272$178$3158
Nevada$258$207$97$51017
Louisiana$258$277$185$2778
District of Columbia$249$194$160$3923
Kentucky$245$234$234$2673
New Mexico$241$252$220$2747
Massachusetts$238$220$95$39219
North Carolina$238$199$192$37019
Illinois$236$204$192$35710
New Hampshire$226$212$95$3824
Connecticut$220$220$157$2865
New Jersey$219$196$157$40150
North Dakota$216$212$173$2664
New York$213$157$121$94541
Ohio$213$217$157$2348
Indiana$206$193$193$26917
Missouri$205$169$169$39216
Maryland$199$188$160$39227
Idaho$185$186$177$20810
Nebraska$178$170$170$25410
Iowa$170$170$170$1702
Kansas$170$170$170$1701
Wyoming$152$152$152$1521
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