Metal-Based Temporization/Splinting (Single Tooth) (D9128) — National Rates

Negotiated reimbursement rates for D9128 across 21 states, sourced from CMS Transparency in Coverage data. 120 rate records.

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National Average Negotiated Rate
$43
120 rate records · 21 states
📊 Data updated monthly · Last refresh: March 2026

About D9128 — Metal-Based Temporization/Splinting (Single Tooth)

D9128 refers to the procedure of metal-based temporization or splinting for a single tooth. This procedure is typically indicated for patients requiring temporary stabilization of a tooth or teeth due to trauma, extensive decay, or prior to definitive restorative treatment. Documentation for this procedure should include clinical notes detailing the reason for temporization, the materials used, and any relevant patient history. Billing for D9128 may vary by payor and state, with some insurance plans covering the procedure under specific circumstances while others may classify it as cosmetic, leading to denials. The average reimbursement for this procedure is around $43.

Reimbursement rates for D9128 vary significantly by state, payor, and provider network. The national average negotiated rate is $43. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D9128

Connecticut
$69
5 records
California
$67
31 records
Arizona
$65
2 records

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Full National Breakdown

Median
$50
Low
$8
High
$106

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
Connecticut$69
California$67
Arizona$65
Oregon$58
Washington$56

↓ Bottom 5

StateAvg Rate
New Jersey$14
Florida$13
Indiana$11
Ohio$10
Kentucky$9

All States — D9128 Average Rates

Connecticut
$69
California
$67
Arizona
$65
Oregon
$58
Washington
$56
Georgia
$46
New York
$44
Colorado
$42
Texas
$38
Utah
$35
Illinois
$25
Virginia
$23
Alabama
$18
Missouri
$17
Wisconsin
$16
Minnesota
$15
New Jersey
$14
Florida
$13
Indiana
$11
Ohio
$10
Kentucky
$9
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
Connecticut$69$90$25$905
California$67$65$39$10631
Arizona$65$65$65$652
Oregon$58$58$58$581
Washington$56$58$11$5820
Georgia$46$46$34$582
New York$44$26$12$1046
Colorado$42$40$26$655
Texas$38$34$22$586
Utah$35$35$35$351
Illinois$25$8$8$583
Virginia$23$24$17$273
Alabama$18$18$18$181
Missouri$17$17$15$192
Wisconsin$16$16$16$162
Minnesota$15$15$9$212
New Jersey$14$14$14$141
Florida$13$13$13$1314
Indiana$11$11$11$111
Ohio$10$10$10$101
Kentucky$9$9$9$99
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