What is the average cost of Myotomy (D7856)?

The national average negotiated reimbursement rate for Myotomy (D7856) is $4,478, based on 5 rate records from CMS Transparency in Coverage data across 2 states.

Which state has the highest Myotomy reimbursement rate?

New York has the highest average negotiated rate for D7856 (Myotomy) at $8,295, based on 1 rate records.

How much does Myotomy cost in South Carolina?

The average negotiated rate for D7856 (Myotomy) in South Carolina is $2,849, which is among the lowest in the nation based on CMS Transparency in Coverage data.

How many providers offer Myotomy nationwide?

Based on CMS Transparency in Coverage data, 3 providers across 2 states have negotiated rates on file for D7856 (Myotomy), totaling 5 rate records.

Myotomy (D7856) — National Rates

Name: Myotomy (D7856) Reimbursement Rates by State — PayorMap
Creator: PayorMap
License: https://creativecommons.org/publicdomain/mark/1.0/
Keywords: myotomy cost, myotomy reimbursement rate, D7856 PPO rate, myotomy negotiated rate, D7856 fee schedule, dental myotomy price, D7856 dental insurance rate

Negotiated reimbursement rates for D7856 across 2 states, sourced from CMS Transparency in Coverage data. 5 rate records.

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About D7856 — Myotomy

Myotomy is a surgical procedure that involves cutting the muscles around the TMJ to relieve pain and improve function. This procedure is indicated for patients with muscle-related disorders or severe limitations in jaw movement. Comprehensive documentation is necessary, including a detailed history of symptoms and previous treatments. The average reimbursement for D7856 is approximately $4, but this can vary widely depending on the insurance provider and state regulations. Some payors may have specific guidelines regarding the conditions under which myotomy is covered.

Reimbursement rates for D7856 vary significantly by state, payor, and provider network. The national average negotiated rate is $4. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Rate Range & Distribution

Full National Breakdown

Median

$2,849

Low

$100

High

$8,295

Highest & Lowest Reimbursement States

↑ Top 5

State	Avg Rate
New York	$8,295
South Carolina	$2,849

↓ Bottom 5

State	Avg Rate
New York	$8,295
South Carolina	$2,849

All States — D7856 Average Rates

New York

$8,295

South Carolina

$2,849

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State-by-State Comparison Table

State	Average	Median	Min	Max	Records
New York	$8,295	$8,295	$8,295	$8,295	1
South Carolina	$2,849	$2,849	$2,849	$2,849	1

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