Negotiated reimbursement rates for D7286 across 47 states, sourced from CMS Transparency in Coverage data. 609 rate records.
Incisional biopsy of oral tissue (soft) involves the surgical removal of a portion of a lesion or abnormal tissue for diagnostic examination. This procedure is clinically indicated when a lesion is too large to be excised entirely or when a definitive diagnosis is needed before treatment. Documentation should include the reason for the biopsy, the specific site of the lesion, and any relevant medical history. Billing for this procedure may vary by payor, with some insurance plans covering the cost while others may require prior authorization. Reimbursement rates also differ by state, reflecting regional healthcare policies and the complexity of the procedure. The average reimbursement for this code is around $228.
Reimbursement rates for D7286 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.
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