Auricular Prosthesis (Replacement) (D5927) — National Rates

About D5927 — Auricular Prosthesis (Replacement)

D5927 refers to the Auricular Prosthesis (Replacement), a procedure that involves creating a prosthetic ear for patients who have lost their ear due to trauma, congenital defects, or surgical removal. Clinical indications include the need for aesthetic restoration and functional improvement. Documentation should include patient history, the reason for the replacement, and any previous prosthetic devices. The average reimbursement for D5927 is approximately $1, but this can vary significantly by payor and state. Some insurance companies may classify this as cosmetic, leading to non-coverage, while others may provide some level of reimbursement. It is essential for dental billing professionals to verify coverage details with each payor to ensure accurate claims submission.

Reimbursement rates for D5927 vary significantly by state, payor, and provider network. The national average negotiated rate is $1. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.