Negotiated reimbursement rates for D7961 across 45 states, sourced from CMS Transparency in Coverage data. 593 rate records.
Buccal/Labial Frenectomy is a surgical procedure that involves the removal of the frenulum, which is the tissue connecting the lip to the gum or the cheek to the gum. This procedure is indicated for patients who experience functional issues, such as difficulty with speech or dental hygiene, due to a tight or abnormal frenulum. Documentation for billing should include a detailed description of the clinical necessity, any symptoms experienced by the patient, and the surgical technique used. Reimbursement for this procedure can vary significantly by payor and state, with average payments around $290. Some insurance plans may require prior authorization or specific documentation to justify the procedure, while others may have limitations on coverage based on the patient's age or the severity of the condition.
Reimbursement rates for D7961 vary significantly by state, payor, and provider network. The national average negotiated rate is $290. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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