Negotiated reimbursement rates for D7285 across 46 states, sourced from CMS Transparency in Coverage data. 673 rate records.
The CDT code D7285 is for an incisional biopsy of hard oral tissue, typically performed to obtain a tissue sample for diagnostic evaluation. This procedure is indicated when there are lesions or abnormalities in the oral cavity that warrant further investigation. Proper documentation should include clinical findings, imaging, and the reason for the biopsy. Reimbursement rates for this service can differ significantly based on the patient's insurance plan and state regulations, with an average reimbursement of around $376. It is essential to verify coverage with payors, as some may have specific requirements for biopsy procedures.
Reimbursement rates for D7285 vary significantly by state, payor, and provider network. The national average negotiated rate is $376. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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