Negotiated reimbursement rates for D5928 across 1 states, sourced from CMS Transparency in Coverage data. 4 rate records.
D5928 is the CDT code for Orbital Prosthesis (Replacement), which involves the creation of a prosthetic eye socket for patients who have lost an eye or have a defect in the orbital area. This procedure is clinically indicated for patients with trauma, congenital defects, or surgical removal of the eye. Comprehensive documentation is necessary, including clinical notes that justify the need for the prosthesis and details of the previous prosthetic device. The average reimbursement for D5928 is around $200, but this can vary widely depending on the payor and state regulations. Some insurance plans may cover this procedure more favorably than others, so dental billing professionals should confirm the specifics of coverage with each payor to facilitate appropriate claims processing.
Reimbursement rates for D5928 vary significantly by state, payor, and provider network. The national average negotiated rate is $200. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
-2+ more states available with Pro ↓
| State | Avg Rate |
|---|---|
| New York | $300 |
| State | Avg Rate |
|---|---|
| New York | $300 |