Negotiated reimbursement rates for D7996 across 2 states, sourced from CMS Transparency in Coverage data. 8 rate records.
D7996 refers to the procedure for mandible augmentation using alloplastic materials. This procedure is clinically indicated for patients who require additional bone support for dental implants or other restorative procedures. Documentation for billing should include detailed notes on the patient's condition, the rationale for the augmentation, and any imaging studies that support the need for the procedure. Reimbursement for D7996 can vary significantly by payor and state, with some insurance plans covering the procedure under specific circumstances while others may classify it as experimental or cosmetic, leading to denials or reduced payments. It is essential to verify coverage with the patient's insurance provider prior to performing the procedure to ensure appropriate reimbursement.
Reimbursement rates for D7996 vary significantly by state, payor, and provider network. The national average negotiated rate is $1. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
-1+ more states available with Pro ↓
| State | Avg Rate |
|---|---|
| New York | $1,315 |
| South Carolina | $1,155 |
| State | Avg Rate |
|---|---|
| New York | $1,315 |
| South Carolina | $1,155 |