Negotiated reimbursement rates for D7490 across 8 states, sourced from CMS Transparency in Coverage data. 122 rate records.
The CDT code D7490 denotes radical resection of the mandible, a significant surgical procedure that involves the removal of a portion of the mandible due to pathology such as tumors or severe infections. Clinical indications for this procedure are serious and typically involve malignancies or extensive bone loss. Documentation must be thorough, including pathology reports, imaging, and a detailed surgical report. Billing for this procedure can be complex, as reimbursement is often low, averaging around $2, which may not cover the costs of the procedure. Variability in reimbursement exists based on the payor, with some private insurers providing better coverage than Medicaid or Medicare, which may have stringent criteria for approval.
Reimbursement rates for D7490 vary significantly by state, payor, and provider network. The national average negotiated rate is $2. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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