Replacement of Lost/Broken Retainer, By Report (D8704) — National Rates

Negotiated reimbursement rates for D8704 across 23 states, sourced from CMS Transparency in Coverage data. 123 rate records.

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National Average Negotiated Rate
$356
123 rate records · 23 states
📊 Data updated monthly · Last refresh: March 2026

About D8704 — Replacement of Lost/Broken Retainer, By Report

D8704 is designated for the replacement of a lost or broken retainer, billed by report. This code is typically used when the replacement involves unique circumstances that require additional documentation to justify the procedure. Clinical indications may include significant wear or damage that impacts the retainer's functionality. Billing notes should include detailed descriptions of the circumstances leading to the replacement. Reimbursement for this code averages about $356, but it can vary widely based on the specifics of the case and the policies of different payors.

Reimbursement rates for D8704 vary significantly by state, payor, and provider network. The national average negotiated rate is $356. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D8704

North Dakota
$431
1 records
Connecticut
$430
1 records
Alabama
$429
1 records

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Full National Breakdown

Median
$388
Low
$51
High
$431

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
North Dakota$431
Connecticut$430
Alabama$429
Kentucky$429
Massachusetts$429

↓ Bottom 5

StateAvg Rate
Tennessee$352
New York$289
Virginia$265
Ohio$250
South Carolina$185

All States — D8704 Average Rates

North Dakota
$431
Connecticut
$430
Alabama
$429
Kentucky
$429
Massachusetts
$429
Georgia
$429
California
$416
Oregon
$410
Washington
$406
Illinois
$390
Michigan
$389
Florida
$386
Texas
$370
New Jersey
$366
Utah
$360
Delaware
$359
Louisiana
$359
Pennsylvania
$359
Tennessee
$352
New York
$289
Virginia
$265
Ohio
$250
South Carolina
$185
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
North Dakota$431$431$431$4311
Connecticut$430$430$430$4301
Alabama$429$429$429$4291
Kentucky$429$429$429$4291
Massachusetts$429$429$429$4292
Georgia$429$429$417$42930
California$416$416$411$4212
Oregon$410$410$410$4101
Washington$406$405$403$4103
Illinois$390$390$390$3901
Michigan$389$388$388$42930
Florida$386$386$380$3912
Texas$370$370$370$3701
New Jersey$366$366$330$4012
Utah$360$360$360$3601
Delaware$359$359$359$3591
Louisiana$359$359$359$3591
Pennsylvania$359$359$359$3596
Tennessee$352$352$275$4292
New York$289$275$275$34013
Virginia$265$265$240$2904
Ohio$250$250$250$2503
South Carolina$185$170$51$4296
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