Negotiated reimbursement rates for D7413 across 15 states, sourced from CMS Transparency in Coverage data. 154 rate records.
D7413 pertains to the excision of a malignant lesion measuring 1.25 cm or less. This procedure is critical for the removal of cancerous tissue and is often performed as part of a broader treatment plan. Clinical indications include the presence of suspicious lesions that require histological examination. Documentation must be meticulous, including the lesion's characteristics, biopsy results, and the surgical approach taken. Reimbursement for D7413 can vary widely based on the patient's insurance plan and state regulations, with an average reimbursement of about $294. Some payors may have specific requirements for pre-authorization or additional documentation due to the nature of malignant lesions.
Reimbursement rates for D7413 vary significantly by state, payor, and provider network. The national average negotiated rate is $294. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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