Negotiated reimbursement rates for D5410 across 29 states, sourced from CMS Transparency in Coverage data. 163 rate records.
D5410 is the CDT code for adjusting a complete upper denture. This procedure is performed to enhance the fit and comfort of the denture, addressing issues such as sore spots or instability. Clinical indications for this adjustment include patient complaints of discomfort, difficulty in chewing, or movement of the denture during function. Proper documentation should include the patient's complaints, any clinical findings, and the adjustments made. The average reimbursement for D5410 is approximately $57, but this can vary based on the patient's insurance plan and state regulations. Some payors may have specific guidelines on how often adjustments can be billed, so dental billing professionals should be aware of these nuances to ensure compliance and optimize reimbursement.
Reimbursement rates for D5410 vary significantly by state, payor, and provider network. The national average negotiated rate is $57. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
26+ more states available with Pro ↓
| State | Avg Rate |
|---|---|
| Minnesota | $79 |
| Connecticut | $78 |
| Georgia | $77 |
| Nevada | $68 |
| Arizona | $67 |
| State | Avg Rate |
|---|---|
| Utah | $34 |
| Indiana | $34 |
| Ohio | $33 |
| Kentucky | $31 |
| Arkansas | $27 |