Negotiated reimbursement rates for D9971 across 37 states, sourced from CMS Transparency in Coverage data. 211 rate records.
Odontoplasty, coded as D9971, involves the reshaping or contouring of the enamel of one or two teeth to improve aesthetics or function. Clinical indications for this procedure include correcting minor irregularities in tooth shape, addressing enamel defects, or preparing teeth for restorative work. Documentation for billing should include a detailed description of the clinical findings, the rationale for the procedure, and any pre- and post-operative photographs if applicable. Reimbursement for D9971 can vary significantly by payor and state, with some insurance plans covering it under cosmetic procedures while others may not cover it at all. Average reimbursement is around $67, but it is essential to verify benefits with each specific payor prior to treatment to ensure proper billing and reimbursement.
Reimbursement rates for D9971 vary significantly by state, payor, and provider network. The national average negotiated rate is $67. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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