Negotiated reimbursement rates for D7980 across 13 states, sourced from CMS Transparency in Coverage data. 168 rate records.
The CDT code D7980 refers to a surgical sialolithotomy, a procedure performed to remove a salivary stone from the duct. This procedure is indicated when a patient experiences symptoms such as pain, swelling, or infection due to a blocked salivary gland. Documentation should include clinical symptoms, imaging studies, and a detailed account of the surgical approach. Reimbursement for D7980 varies by payor and state, with some insurers offering higher reimbursement rates for more complex cases. The average reimbursement for this procedure is approximately $399, but actual amounts may differ based on the specifics of the patient's insurance plan and location.
Reimbursement rates for D7980 vary significantly by state, payor, and provider network. The national average negotiated rate is $399. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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| State | Avg Rate |
|---|---|
| Utah | $770 |
| Arizona | $761 |
| Nevada | $723 |
| Pennsylvania | $642 |
| New York | $579 |
| State | Avg Rate |
|---|---|
| Texas | $501 |
| Wisconsin | $492 |
| New Jersey | $462 |
| Ohio | $380 |
| South Carolina | $248 |