Negotiated reimbursement rates for D6197 across 6 states, sourced from CMS Transparency in Coverage data. 22 rate records.
D6197 is the code for the replacement of an attachment for an implant denture. This procedure is necessary when the existing attachment has worn out or become damaged, impacting the retention of the denture. Clinical indications include loss of retention or stability of the implant-supported denture. Proper documentation should include the reason for replacement, details of the previous attachment, and any clinical findings. Reimbursement can vary widely depending on the insurance provider and state regulations, with some payors covering it as part of the overall denture service. The average reimbursement for this procedure is approximately $89.
Reimbursement rates for D6197 vary significantly by state, payor, and provider network. The national average negotiated rate is $89. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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| State | Avg Rate |
|---|---|
| Texas | $146 |
| California | $111 |
| Indiana | $105 |
| District of Columbia | $95 |
| New York | $86 |
| State | Avg Rate |
|---|---|
| California | $111 |
| Indiana | $105 |
| District of Columbia | $95 |
| New York | $86 |
| South Carolina | $64 |