Negotiated reimbursement rates for D7560 across 16 states, sourced from CMS Transparency in Coverage data. 161 rate records.
D7560 is the code for Maxillary Sinusotomy for Removal of Tooth Fragment. This procedure is performed when a tooth fragment is lodged in the maxillary sinus, often due to extraction complications. Clinical indications include persistent sinusitis or pain following tooth extraction. Documentation should include imaging studies that demonstrate the presence of the fragment and a detailed surgical report. Reimbursement for D7560 is generally low, averaging around $1, and varies widely by payor and state. Many insurance plans may not cover this procedure unless it is deemed medically necessary, so it is important for dental billing professionals to check the specific policy details and obtain any necessary pre-authorizations before proceeding with the procedure.
Reimbursement rates for D7560 vary significantly by state, payor, and provider network. The national average negotiated rate is $1. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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