Myotomy (D7856) — National Rates

Negotiated reimbursement rates for D7856 across 2 states, sourced from CMS Transparency in Coverage data. 5 rate records.

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National Average Negotiated Rate
$4,478
5 rate records · 2 states
📊 Data updated monthly · Last refresh: March 2026

About D7856 — Myotomy

Myotomy is a surgical procedure that involves cutting the muscles around the TMJ to relieve pain and improve function. This procedure is indicated for patients with muscle-related disorders or severe limitations in jaw movement. Comprehensive documentation is necessary, including a detailed history of symptoms and previous treatments. The average reimbursement for D7856 is approximately $4, but this can vary widely depending on the insurance provider and state regulations. Some payors may have specific guidelines regarding the conditions under which myotomy is covered.

Reimbursement rates for D7856 vary significantly by state, payor, and provider network. The national average negotiated rate is $4. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D7856

New York
$8,295
1 records
South Carolina
$2,849
1 records

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Full National Breakdown

Median
$2,849
Low
$100
High
$8,295

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
New York$8,295
South Carolina$2,849

↓ Bottom 5

StateAvg Rate
New York$8,295
South Carolina$2,849

All States — D7856 Average Rates

New York
$8,295
South Carolina
$2,849
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
New York$8,295$8,295$8,295$8,2951
South Carolina$2,849$2,849$2,849$2,8491
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