Negotiated reimbursement rates for D5911 across 1 states, sourced from CMS Transparency in Coverage data. 3 rate records.
D5911 refers to the procedure of creating a facial moulage, which is a sectional impression used for prosthetic applications. This procedure is clinically indicated for patients requiring a detailed representation of facial features for the fabrication of prosthetics, particularly in cases of facial deformities or after surgical interventions. Proper documentation is essential, including patient history, clinical notes, and the specific need for the moulage to support the medical necessity of the procedure. Reimbursement for D5911 can vary significantly by payor and state, with average payments around $144. Some insurance plans may have specific criteria for coverage, while others may not reimburse for this procedure at all, necessitating a thorough understanding of each payor's policies to optimize billing outcomes.
Reimbursement rates for D5911 vary significantly by state, payor, and provider network. The national average negotiated rate is $144. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
-2+ more states available with Pro ↓
| State | Avg Rate |
|---|---|
| New York | $166 |
| State | Avg Rate |
|---|---|
| New York | $166 |