Negotiated reimbursement rates for D0477 across 2 states, sourced from CMS Transparency in Coverage data. 5 rate records.
D0477 is used for a consultation provided by a pathologist regarding a submitted specimen. This procedure is clinically indicated when a dentist requires expert interpretation of a specimen to diagnose a condition or determine treatment options. Proper documentation should include the clinical history, the reason for the consultation, and any findings from the pathologist. Reimbursement for D0477 can vary based on the payor's policies and the state in which the service is rendered, with an average reimbursement of approximately $118. Some payors may require additional documentation or pre-authorization, so dental billing professionals should ensure compliance with specific payor requirements to facilitate timely reimbursement.
Reimbursement rates for D0477 vary significantly by state, payor, and provider network. The national average negotiated rate is $118. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
-1+ more states available with Pro ↓
| State | Avg Rate |
|---|---|
| New York | $130 |
| South Carolina | $114 |
| State | Avg Rate |
|---|---|
| New York | $130 |
| South Carolina | $114 |