Mandibular Resection Prosthesis (w/o Guide Flange) (D5934) — National Rates

About D5934 — Mandibular Resection Prosthesis (w/o Guide Flange)

D5934 is associated with a mandibular resection prosthesis without a guide flange, which is used to restore function and aesthetics for patients who have undergone mandibular resection. This type of prosthesis is critical for patients who have lost part of their mandible due to surgical intervention. Clinical indications include the need for restoration of occlusion and facial contour. Documentation should detail the surgical history, the design of the prosthesis, and the patient's functional needs. Reimbursement for D5934 can vary, with some payors offering full coverage while others may impose limitations based on the specifics of the case and the necessity of the prosthesis.

Reimbursement rates for D5934 vary significantly by state, payor, and provider network. The national average negotiated rate is $5. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.