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HCPCS D1353

SEALANT REPAIR PER TOOTH

Reported by 62 hospitals in the network.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

National pricing summary

Low

$12

Average

$365

Median

$73

High

$11.0k

Hospitals reporting this code

#HospitalLocation
1VHS Acquisition Subsidiary Number 9 IncNatick, MA$29$33$32$33$2
2VHS Acquisition Subsidiary Number 9 IncFramingham, MA$29$33$32$33$2
3VHS Acquisition Subsidiary Number 7 IncWorcester, MA$36$40$39$40$2
4Wesley Health System LLCHattiesburg, MS$91$10.3k$11.0k$23.7k$6.5k
5St Joseph’s Health Services IncHillsboro, WI$23$129$117$142$36
6Gundersen Luthern Medical Center IncLa Crosse, WI$22$23$29$62$15
7Gundersen Palmer Lutheran Hospital and Clinic IncWest Union, IA$23$70$73$129$50
8Moundview Memorial Hospital and Clinics, Inc.Friendship, WI$23$142$125$142$42
9Memorial Hospital of BoscobelBoscobel, WI$23$110$99$110$29
10Tri-County Memorial Hospital IncWhitehall, WI$23$111$98$111$31
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