Negotiated reimbursement rates for D7952 across 8 states, sourced from CMS Transparency in Coverage data. 45 rate records.
Sinus augmentation via lateral open approach is a surgical procedure performed to increase the volume of bone in the upper jaw, specifically in the area of the maxillary sinus, to facilitate the placement of dental implants. Clinical indications for this procedure include insufficient bone height due to sinus pneumatization or bone resorption following tooth loss. Documentation for billing should include pre-operative imaging, surgical notes, and post-operative evaluations. Reimbursement for this procedure can vary significantly by payor and state, with some insurance plans covering a portion of the costs while others may consider it elective or cosmetic, leading to out-of-pocket expenses for patients.
Reimbursement rates for D7952 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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