Negotiated reimbursement rates for D7963 across 28 states, sourced from CMS Transparency in Coverage data. 154 rate records.
Frenuloplasty is a surgical procedure that modifies the frenulum to improve its function or appearance, often performed when a frenectomy alone is insufficient. This procedure may be indicated for patients with significant restrictions in tongue or lip movement due to a tight frenulum. Documentation for billing should include a comprehensive clinical rationale, details of the surgical technique, and any associated symptoms. The average reimbursement for this procedure is around $346, but variations exist based on the patient's insurance plan and state guidelines. Some payors may have specific criteria for approving this procedure, including the need for prior authorization or documentation of functional limitations.
Reimbursement rates for D7963 vary significantly by state, payor, and provider network. The national average negotiated rate is $346. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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