Negotiated reimbursement rates for D5512 across 40 states, sourced from CMS Transparency in Coverage data. 444 rate records.
D5512 is the code used for repairing a broken complete denture base for the lower arch. This procedure is indicated when the lower denture has sustained damage that affects its function or fit. Documentation should include the nature of the break, any relevant patient history, and the treatment plan. Average reimbursement for this procedure is around $120, but it can vary based on the patient's insurance plan and state regulations. Some payors may have specific criteria for coverage, so it is advisable to check the patient's benefits prior to treatment to ensure proper billing.
Reimbursement rates for D5512 vary significantly by state, payor, and provider network. The national average negotiated rate is $120. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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| State | Avg Rate |
|---|---|
| Connecticut | $198 |
| New Hampshire | $186 |
| New Mexico | $184 |
| Alaska | $176 |
| California | $163 |
| State | Avg Rate |
|---|---|
| Minnesota | $90 |
| Tennessee | $82 |
| Arkansas | $73 |
| Alabama | $72 |
| Iowa | $60 |