Negotiated reimbursement rates for D7451 across 47 states, sourced from CMS Transparency in Coverage data. 723 rate records.
D7451 is the code for the removal of a benign odontogenic cyst larger than 1.25 cm. This procedure is necessary for excising larger non-cancerous cysts that can lead to complications such as infection or damage to adjacent teeth and structures. Clinical indications for D7451 include the presence of a significant benign cyst that warrants surgical intervention due to its size and potential impact on the patient's oral health. Comprehensive documentation is essential for billing, including the cyst's dimensions, location, surgical technique, and any complications encountered. Reimbursement for D7451 averages around $781, with variations based on payor policies and state regulations. Some insurance plans may have specific guidelines regarding the removal of larger odontogenic cysts, which can affect reimbursement. Therefore, dental billing professionals should confirm the patient's insurance benefits and seek pre-authorization when necessary to ensure proper payment.
Reimbursement rates for D7451 vary significantly by state, payor, and provider network. The national average negotiated rate is $781. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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