Your team builds the medical necessity, cross-codes the CDT to CPT, clears the gap exception and files a clean claim on a CMS-1500. The one number nobody in dental-medical billing can show you is the allowed amount, before the claim goes out. That is the number on this page.
No PHI required. No sign-up to read this page. Built on public federal Transparency-in-Coverage filings, the NPI Registry, and the CMS Physician Fee Schedule.
Live counts, read from our public stats endpoint when this page loaded. Separately, the universe we index toward is 314M+ records, 500+ payers, 50 states and 9.2M+ NPIs. The four figures above are what is live right now, not the scope target.
Cross-coders, attachment clearinghouses, concierge filing, AR dashboards. The category is well served on workflow and completely unserved on rate. The allowed amount is the one variable your team has to guess, and it is the variable that decides whether the case is worth taking.
Remaining deductible, coinsurance, and the practice fee all come off the call. The allowed amount does not. Practitioner guidance in this niche is explicit that commercial medical insurers do not typically reveal their fees, and that even the payer's own representative may not be able to give the number in advance.
Offices estimate the allowed amount from previous remittances and tell the patient the figure is approximate. That claim history is a real rate database. It is also small, retrospective, specific to the payers you already lost or won, and silent on the payer you are about to negotiate with.
Billing services in this niche are commonly paid as a percentage of the allowed amount or of collections. The revenue model already runs on the number. Better visibility into it compounds directly into the billing company's own margin, not just the practice's.
Contracted rate distributions for the oral surgery, maxillofacial radiology and office visit codes that carry a dental-medical book. Pick a state. Every figure below is fetched live when you change it. Nothing on this page is stored, illustrative, or modeled from an average.
| Code | Medicare | Market P25 | Market P50 | Market P75 | P90 target | Observations |
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Reading the rate index
Pulling contracted rate distributions for each code from public federal Transparency-in-Coverage filings. This takes a few seconds because it is a live query, not a cached page.
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A rate intelligence company that will not tell you where its data stops is asking you to take the rest on faith. This is the map. It is the reason to believe the board above.
How to read the board. The market columns are a statewide, payer-blind peer distribution computed from public Transparency-in-Coverage filings. That is a coarser rung than the local peer median we score a named NPI against inside the app, and it is labelled as statewide everywhere it appears here rather than being passed off as something narrower. Medicare is the CMS Physician Fee Schedule allowed amount, shown as a band where a state prices in more than one locality. Counts are rate observations, not distinct providers.
Not features. The points in a dental-medical billing week where knowing the number instead of estimating it changes what your team does next.
Walk in with the expected range for the code and the payer already in front of you, and the call becomes a confirmation instead of an investigation.
The out-of-pocket estimate is deductible, coinsurance, fee and allowed amount. Three are known. Filling the fourth turns an approximate number into a defensible one.
A practice charge set below what a payer already allows is money the payer never has to refuse. That gap is visible the moment both numbers sit on one screen.
Compare the allowed amount actually posted on the remittance against the market distribution for that code and state, across every NPI in your book at once.
Go into the conversation with the distribution and a documented target rather than a request. Device codes stay out of the ask by rule.
Hand your dental practices a rate intelligence page under your own name. It is the part of a monthly report a practice cannot get anywhere else.
The fastest way to judge this is against a practice you already bill for. Run a single NPI and see what its payers are contracted at, where each one sits against its local peer cohort, and which codes carry a documented gap. If you run a book of practices, that is a conversation rather than a checkout, so start with a call.