Bridge Retainer — Onlay, Cast Base Metal (2 Surf) (D6612) — National Rates

Negotiated reimbursement rates for D6612 across 51 states, sourced from CMS Transparency in Coverage data. 740 rate records.

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National Average Negotiated Rate
$581
740 rate records · 51 states
📊 Data updated monthly · Last refresh: March 2026

About D6612 — Bridge Retainer — Onlay, Cast Base Metal (2 Surf)

D6612 describes a bridge retainer procedure involving an onlay made of cast base metal with two surfaces. This procedure is typically indicated for patients who require a cost-effective solution for tooth restoration. Proper documentation should include the clinical justification for using base metal, details of the tooth preparation, and any relevant diagnostic imaging. Reimbursement for D6612 can vary significantly by payor and state, with an average reimbursement of approximately $581. Some insurance plans may have specific guidelines regarding coverage for base metal restorations, impacting the billing process.

Reimbursement rates for D6612 vary significantly by state, payor, and provider network. The national average negotiated rate is $581. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D6612

Maine
$946
3 records
Washington
$918
17 records
Oregon
$851
11 records

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Full National Breakdown

Median
$549
Low
$83
High
$1,242

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
Maine$946
Washington$918
Oregon$851
Alaska$805
District of Columbia$785

↓ Bottom 5

StateAvg Rate
Rhode Island$411
Montana$392
Nebraska$365
Iowa$306
South Dakota$213

All States — D6612 Average Rates

Maine
$946
Washington
$918
Oregon
$851
Alaska
$805
District of Columbia
$785
Massachusetts
$741
Connecticut
$726
Georgia
$693
Indiana
$692
Delaware
$660
Colorado
$655
Mississippi
$646
California
$644
New Hampshire
$633
Florida
$627
Kentucky
$624
South Carolina
$623
Wisconsin
$614
Virginia
$613
Arizona
$612
New Jersey
$589
New York
$584
Hawaii
$576
Michigan
$574
New Mexico
$572
Missouri
$566
Maryland
$553
Oklahoma
$550
North Carolina
$549
Ohio
$549
Pennsylvania
$536
Texas
$534
Alabama
$534
Utah
$526
Illinois
$516
Vermont
$509
Louisiana
$509
Kansas
$506
Nevada
$494
Wyoming
$490
North Dakota
$478
Tennessee
$455
Arkansas
$436
Idaho
$432
Minnesota
$424
West Virginia
$416
Rhode Island
$411
Montana
$392
Nebraska
$365
Iowa
$306
South Dakota
$213
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
Maine$946$1,000$788$1,0503
Washington$918$1,077$405$1,24217
Oregon$851$887$662$1,16811
Alaska$805$737$589$1,1685
District of Columbia$785$761$631$9643
Massachusetts$741$773$411$9966
Connecticut$726$732$616$8254
Georgia$693$721$549$79529
Indiana$692$705$665$7073
Delaware$660$676$485$8183
Colorado$655$705$403$79114
Mississippi$646$646$646$6461
California$644$682$213$90865
New Hampshire$633$391$391$9965
Florida$627$642$348$85336
Kentucky$624$651$255$66326
South Carolina$623$549$345$99819
Wisconsin$614$726$255$8125
Virginia$613$606$432$96419
Arizona$612$587$405$99615
New Jersey$589$518$327$1,05023
New York$584$538$327$1,00026
Hawaii$576$562$454$7116
Michigan$574$533$403$1,16813
New Mexico$572$559$559$59824
Missouri$566$615$213$70213
Maryland$553$496$436$75936
Oklahoma$550$620$410$6203
North Carolina$549$549$270$72851
Ohio$549$545$213$79810
Pennsylvania$536$496$431$73013
Texas$534$544$213$78322
Alabama$534$534$467$67210
Utah$526$522$434$6254
Illinois$516$520$213$7837
Vermont$509$509$391$6272
Louisiana$509$508$381$75512
Kansas$506$540$213$6606
Nevada$494$470$470$80077
Wyoming$490$490$346$6352
North Dakota$478$385$348$7035
Tennessee$455$438$340$5916
Arkansas$436$377$377$5919
Idaho$432$424$213$59415
Minnesota$424$405$255$83825
West Virginia$416$416$416$4161
Rhode Island$411$411$411$4111
Montana$392$392$392$3921
Nebraska$365$441$213$4413
Iowa$306$213$213$66011
South Dakota$213$213$213$2131
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