Negotiated reimbursement rates for D7460 across 16 states, sourced from CMS Transparency in Coverage data. 172 rate records.
The CDT code D7460 refers to the removal of a benign non-odontogenic cyst measuring 1.25 cm or less. This procedure is typically indicated when a cyst is asymptomatic but may pose a risk for infection or other complications. Documentation for this procedure should include clinical notes detailing the size, location, and nature of the cyst, as well as any imaging studies that support the diagnosis. Billing professionals should note that reimbursement for this procedure can vary significantly by payor and state, with average reimbursements around $425. Some insurance plans may require prior authorization or specific documentation to justify the procedure, so it is essential to check individual payor guidelines before submission.
Reimbursement rates for D7460 vary significantly by state, payor, and provider network. The national average negotiated rate is $425. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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