Browse All CDT Codes

Photobiomodulation - 1st 15 mins

Photobiomodulation - subsq 15 mins

GA with advanced airway - 1st 15m

GA with advanced airway - subsq 15m

Nitrous oxide single agent

Minimal sedation - enteral

Moderate sedation - enteral

Mod sedation non-IV - 1st 15m

Mod sedation non-IV - subsq 15m

Neuromodulators (Botox)

Dermal fillers

Clean/inspect occlusal guard

Custom clear temp appliance

Place custom clear temp appliance

palliative treatment of dental pain per visit

fixed partial denture sectioning

temporomandibular joint dysfunction non-invasive physical therapies

local anesthesia not in conjunction with operative or surgical procedures

regional block anesthesia

trigeminal division block anesthesia

local anesthesia in conjunction with operative or surgical procedures

evaluation for moderate sedation, deep sedation or general anesthesia

deep sedation/general anesthesia first 15 minutes

deep sedation/general anesthesia each subsequent 15 minute increment

intravenous moderate (conscious) sedation/analgesia — first 15 minutes

intravenous moderate (conscious) sedation/analgesia — each subsequent 15 minute increment

non-intravenous conscious sedation

consultation — diagnostic service provided by dentist or physician other than requesting dentist or physician

consultation with a medical health care professional

house/extended care facility call

hospital or ambulatory surgical center call

office visit for observation (during regularly scheduled hours) — no other services performed

office visit after regularly scheduled hours

case presentation, subsequent to detailed and extensive treatment planning

therapeutic parenteral drug, single administration

therapeutic parenteral drugs, two or more administrations, different medications

infiltration of sustained release therapeutic drug, per quadrant

drugs or medicaments dispensed in the office for home use

occlusal guard hard appliance, full arch

occlusal guard soft appliance, full arch

occlusal guard hard appliance, partial arch

custom sleep apnea appliance fabrication and placement

adjustment of custom sleep apnea appliance

repair of custom sleep apnea appliance

occlusion analysis mounted case

occlusal adjustment limited

occlusal adjustment complete

reline custom sleep apnea appliance (indirect)

duplicate/copy patient's records

enamel microabrasion

odontoplasty per tooth

external bleaching per arch performed in office

external bleaching per tooth

internal bleaching per tooth

external bleaching for home application, per arch; includes materials and fabrication of custom trays

sales tax

missed appointment

cancelled appointment

certified translation or sign-language services per visit

dental case management addressing appointment compliance barriers

dental case management coordination of care

dental case management motivational interviewing

dental case management patient education to improve oral health literacy

teledentistry synchronous; real-time encounter

teledentistry asynchronous; information stored and forwarded to dentist for subsequent review

dental case management care for patients with special health care needs

unspecified adjunctive procedure, by report

periodic oral evaluation established patient

limited oral evaluation problem focused

oral evaluation for a patient under three years of age and counseling with primary caregiver

comprehensive oral evaluation - new or established patient

detailed and extensive oral evaluation - problem focused, by report

re-evaluation - limited, problem focused (established patient; not post-operative visit)

re-evaluation - post-operative office visit

comprehensive periodontal evaluation - new or established patient

screening of patient

assessment of patient

Intraoral comprehensive series

intraoral - periapical first radiographic image

intraoral - periapical each additional radiographic image

intraoral - occlusal radiographic image

extra-oral - 2D projection radiographic image created using a stationary radiation source, and detector

extra-oral posterior dental radiographic image

bitewing single radiographic image

bitewings two radiographic images

bitewings three radiographic images

bitewings four radiographic images

vertical bitewings 7 to 8 radiographic images

sialography

temporomandibular joint arthrogram, including injection

other temporomandibular joint radiographic images, by report

tomographic survey

panoramic radiographic image

2D cephalometric radiographic image acquisition, measurement and analysis

2D oral/facial photographic image obtained intra-orally or extra-orally

cone beam CT capture and interpretation with limited field of view less than one whole jaw

cone beam CT capture and interpretation with field of view of one full dental arch mandible

cone beam CT capture and interpretation with field of view of one full dental arch maxilla, with or without cranium

cone beam CT capture and interpretation with field of view of both jaws; with or without cranium

cone beam CT capture and interpretation for TMJ series including two or more exposures

maxillofacial MRI capture and interpretation

maxillofacial ultrasound capture and interpretation

sialoendoscopy capture and interpretation

intraoral tomosynthesis comprehensive series of radiographic images

intraoral tomosynthesis bitewing radiographic image

intraoral tomosynthesis periapical radiographic image

cone beam CT image capture with limited field of view less than whole jaw

cone beam CT image capture with field of view of one full dental arch mandible

cone beam CT image capture with field of view of one full dental arch maxilla, with or without cranium

cone beam CT image capture with field of view of both jaws, with or without cranium

cone beam CT image capture for TMJ series including two or more exposures

maxillofacial MRI image capture

maxillofacial ultrasound image capture

intraoral tomosynthesis comprehensive series of radiographic images image capture only

intraoral tomosynthesis bitewing radiographic image image capture only

intraoral tomosynthesis periapical radiographic image image capture only

interpretation of diagnostic image by practitioner not associated with capture of the image, including report

virtual treatment simulation using 3D image volume surface or scan

digital subtraction of two or more images or image volumes of the same modality

fusion of two or more 3D image volumes of one or more modalities

3D printing of 3D dental surface scan

HbA1c in-office point of service testing

blood glucose level test in-office using glucose meter

laboratory processing of microbial specimen to include culture and sensitivity studies, preparation and transmission of written report

collection of microorganisms for culture and sensitivity

viral culture

collection and preparation of saliva sample for laboratory diagnostic testing

analysis of saliva sample

assessment of salivary flow by measurement

collection and preparation of genetic sample material for laboratory analysis and report

genetic test for susceptibility to diseases specimen analysis

caries susceptibility tests

Saliva sample point-of-care

adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions, not to include cytology biopsy procedures

pulp vitality tests

Test for cracked tooth

diagnostic casts

accession of tissue, gross examination, preparation and transmission of written report

accession of tissue, gross and microscopic examination, preparation and transmission of written report

accession of tissue, gross and microscopic examination, including assessment of surgical margins for presence of disease, preparation and transmission of written report

decalcification procedure

special stains for microorganisms

special stains, not for microorganisms

immunohistochemical stains

tissue in-situ hybridization, including interpretation

accession of exfoliative cytologic smears, microscopic examination, preparation and transmission of written report

electron microscopy

direct immunofluorescence

indirect immunofluorescence

consultation on slides prepared elsewhere

consultation, including preparation of slides from biopsy material supplied by referring source

laboratory accession of transepithelial cytologic sample, microscopic examination, preparation and transmission of written report

other oral pathology procedures, by report

non-ionizing diagnostic procedure capable of quantifying, monitoring, and recording changes in structure of enamel, dentin, and cementum

caries risk assessment and documentation, with a finding of low risk

caries risk assessment and documentation, with a finding of moderate risk

caries risk assessment and documentation, with a finding of high risk

antigen testing for a public health related pathogen, including coronavirus

antibody testing for a public health related pathogen, including coronavirus

molecular testing for a public health related pathogen, including coronavirus

panoramic radiographic image image capture only

2-D cephalometric radiographic image image capture only

2-D oral/facial photographic image obtained intra-orally or extra-orally image capture only

extra-oral posterior dental radiographic image image capture only

intraoral occlusal radiographic image image capture only

intraoral periapical radiographic image image capture only

intraoral bitewing radiographic image image capture only

intraoral comprehensive series of radiographic images image capture only

3D intraoral surface scan - direct

3D dental surface indirect scan

3D facial surface direct scan

3D facial surface indirect scan

unspecified diagnostic procedure, by report

endodontic therapy, anterior tooth (excluding final restoration)

endodontic therapy, premolar tooth (excluding final restoration)

endodontic therapy, molar tooth (excluding final restoration)

treatment of root canal obstruction; non-surgical access

incomplete endodontic therapy; inoperable, unrestorable or fractured tooth

internal root repair of perforation defects

pulpal therapy (resorbable filling) anterior, primary tooth (excluding final restoration)

pulpal therapy (resorbable filling) posterior, primary tooth (excluding final restoration)

pulp cap direct (excluding final restoration)

pulp cap indirect (excluding final restoration)

therapeutic pulpotomy (excluding final restoration) removal of pulp coronal to the dentinocemental junction and application of medicament

pulpal debridement, primary and permanent teeth

partial pulpotomy for apexogenesis permanent tooth with incomplete root development

retreatment of previous root canal therapy anterior

retreatment of previous root canal therapy premolar

retreatment of previous root canal therapy molar

apexification/recalcification initial visit (apical closure/calcific repair of perforations, root resorption, etc.)

apexification/recalcification interim medication replacement

apexification/recalcification final visit (includes completed root canal therapy apical closure/calcific repair of perforations, root resorption, etc.)

pulpal regeneration initial visit

pulpal regeneration interim medication replacement

pulpal regeneration completion of treatment

apicoectomy anterior

apicoectomy premolar (first root)

apicoectomy molar (first root)

apicoectomy (each additional root)

bone graft in conjunction with periradicular surgery per tooth, single site

bone graft in conjunction with periradicular surgery each additional contiguous tooth in the same surgical site

retrograde filling per root

biologic materials to aid in soft and osseous tissue regeneration in conjunction with periradicular surgery

guided tissue regeneration, resorbable barrier, per site, in conjunction with periradicular surgery

root amputation per root

endodontic endosseous implant

intentional re-implantation (including necessary splinting)

surgical repair of root resorption anterior

surgical repair of root resorption premolar

surgical repair of root resorption molar

surgical exposure of root surface without apicoectomy or repair of root resorption anterior

surgical exposure of root surface without apicoectomy repair of root resorption premolar

surgical exposure of root surface without apicoectomy repair of root resorption molar

surgical procedure for isolation of tooth with rubber dam

intraorifice barrier

hemisection (including any root removal), not including root canal therapy

decoronation or submergence of an erupted tooth

canal preparation and fitting of preformed dowel or post

unspecified endodontic procedure, by report

surgical placement of implant body: endosteal implant

surgical access to an implant body (second stage implant surgery)

surgical placement of interim implant body for transitional prosthesis: endosteal implant

surgical placement of mini implant

surgical placement: eposteal implant

Implant scaling peri-implantitis

surgical placement: transosteal implant

abutment supported porcelain/ceramic crown

abutment supported porcelain fused to metal crown (high noble metal)

abutment supported porcelain fused to metal crown (predominantly base metal)

abutment supported porcelain fused to metal crown (noble metal)

abutment supported cast metal crown (high noble metal)

abutment supported cast metal crown (predominantly base metal)

abutment supported cast metal crown (noble metal)

implant supported porcelain/ceramic crown

implant supported porcelain fused to high noble alloys crown

implant supported high noble alloys crown

abutment supported retainer for porcelain/ceramic FPD

abutment supported retainer for porcelain fused to metal FPD (high noble metal)

abutment supported retainer for porcelain fused to metal FPD (predominantly base metal)

abutment supported retainer for porcelain fused to metal FPD (noble metal)

abutment supported retainer for cast metal (high noble metal) FPD

abutment supported retainer for cast metal (predominantly base metal) FPD

abutment supported retainer for cast metal (noble metal) FPD

implant supported retainer for ceramic FPD

implant supported retainer for FPD porcelain fused to high noble alloys

implant supported retainer for metal FPD high noble alloys

Implant maint fixed hybrid removed

Scale/debride implant w/ mucositis

implant supported porcelain fused to predominantly base alloys crown

implant supported porcelain fused to noble alloys crown

implant supported porcelain fused to titanium or titanium alloys crown

interim implant crown

implant supported predominantly base alloys crown

implant supported noble alloys crown

implant supported titanium and titanium alloys crown

Implant screw retorque

repair implant supported prosthesis, by report

replacement of replaceable part of semi-precision or precision attachment of implant/abutment supported prosthesis, per attachment

re-cement or re-bond implant/abutment supported crown

re-cement or re-bond implant/abutment supported fixed partial denture

abutment supported titanium and titanium alloys crown

repair implant abutment, by report

remove broken implant retaining screw

abutment supported porcelain fused to titanium or titanium alloys crown

implant supported retainer porcelain fused to predominantly base alloys

implant supported retainer for FPD porcelain fused to noble alloys

surgical removal of implant body

debridement of peri-implant defect or single implant, and surface cleaning of the exposed implant surfaces, including flap entry and closure

debridement and contouring of peri-implant defect osseous defects surrounding single implant and includes surface cleaning of the exposed implant surfaces, including flap entry and closure

bone graft for repair of peri-implant defect does not include flap entry and closure

bone graft at time of implant placement

removal of implant body not requiring bone removal or flap elevation

guided tissue regeneration resorbable barrier, per implant

guided tissue regeneration non-resorbable barrier, per implant

implant/abutment supported interim fixed denture for edentulous arch maxillary

implant supported retainer porcelain fused to titanium and titanium alloys

implant supported retainer for metal FPD predominantly base alloys

implant supported retainer for metal FPD noble alloys

implant supported retainer for metal FPD titanium and titanium alloys

Implant maint fixed hybrid (not removed)

radiographic/surgical implant index, by report

Implant screw replacement

abutment supported retainer for titanium crown FPD and titanium alloys

abutment supported retainer porcelain fused to titanium and titanium alloys

Remove indirect implant rest

replacement of restorative material used to close an access opening of screw-retained implant supported prosthesis, per implant

remove interim implant component

unspecified implant procedure, by report

Placement of interim implant abutment

connecting bar implant supported or abutment supported

prefabricated abutment includes modification and placement

custom fabricated abutment includes placement

implant/abutment supported removable denture for edentulous maxillary arch

implant/abutment supported removable denture for edentulous mandibular arch

implant/abutment supported removable denture for partially edentulous maxillary arch

implant/abutment supported removable denture for partially edentulous mandibular arch

implant/abutment supported fixed denture for edentulous maxillary arch

implant/abutment supported fixed denture for edentulous mandibular arch

implant/abutment supported fixed denture for partially edentulous maxillary arch

implant/abutment supported fixed denture for partially edentulous mandibular arch

implant/abutment supported interim fixed denture for edentulous mandibular arch

semi-precision abutment placement

semi-precision attachment placement

Maxillary guidance prosthesis w/ flange

facial moulage (sectional)

facial moulage (complete)

nasal prosthesis

auricular prosthesis

orbital prosthesis

ocular prosthesis

facial prosthesis

nasal septal prosthesis

ocular prosthesis, interim

cranial prosthesis

facial augmentation implant prosthesis

nasal prosthesis, replacement

auricular prosthesis, replacement

orbital prosthesis, replacement

facial prosthesis, replacement

Maxillary guidance prosthesis w/o flange

obturator prosthesis, surgical

obturator prosthesis, definitive

obturator prosthesis, modification

mandibular resection prosthesis with guide flange

mandibular resection prosthesis without guide flange

obturator prosthesis, interim

trismus appliance (not for TMD treatment)

Resection prosthesis max complete

Resection prosthesis man complete

Resection prosthesis max partial

Resection prosthesis man partial

Resection prosthesis max implant/abutment

Resection prosthesis man implant/abutment

Resection prosthesis max partial implant

Resection prosthesis man partial implant

Resection prosthesis max fixed implant

Resection prosthesis man fixed implant

Resection prosthesis max fixed partial

Resection prosthesis man fixed partial

feeding aid

speech aid prosthesis, pediatric

speech aid prosthesis, adult

palatal augmentation prosthesis

palatal lift prosthesis, definitive

palatal lift prosthesis, interim

palatal lift prosthesis, modification

speech aid prosthesis, modification

surgical stent

radiation carrier

radiation shield

radiation cone locator

fluoride gel carrier

commissure splint

surgical splint

vesiculobullous disease medicament carrier

adjust maxillofacial prosthetic appliance, by report

maintenance and cleaning of maxillofacial prosthesis (extra-oral or intra-oral) other than required adjustments, by report

periodontal medicament carrier with peripheral seal — laboratory processed maxillary

periodontal medicament carrier with peripheral seal — laboratory processed mandibular

unspecified maxillofacial prosthesis, by report

application of desensitizing medicament

application of desensitizing resin for cervical and/or root surface, per tooth

pre-visit patient screening

behavior management, by report

treatment of complications (post-surgical) — unusual circumstances, by report

cleaning and inspection of removable complete denture, maxillary

cleaning and inspection of removable complete denture, mandibular

cleaning and inspection of removable partial denture, maxillary

cleaning and inspection of removable partial denture, mandibular

fabrication of athletic mouthguard

repair and/or reline of occlusal guard

occlusal guard adjustment

extraction, coronal remnants — primary tooth

extraction, erupted tooth or exposed root (elevation and/or forceps removal)

extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation of mucoperiosteal flap if indicated

removal of impacted tooth — soft tissue

removal of impacted tooth — partially bony

removal of impacted tooth — completely bony

removal of impacted tooth — completely bony, with unusual surgical complications

removal of residual tooth roots (cutting procedure)

coronectomy intentional partial tooth removal, impacted teeth only

oroantral fistula closure

primary closure of sinus perforation

tooth re-implantation and/or stabilization of accidentally evulsed or displaced tooth

tooth transplantation (includes re-implantation from one site to another and splinting and/or stabilization)

exposure of unerupted tooth

mobilization of erupted or malpositioned tooth to aid eruption

placement of device to facilitate eruption of impacted tooth

incisional biopsy of oral tissue hard (bone, tooth)

incisional biopsy of oral tissue soft

exfoliative cytological sample collection

brush biopsy transepithelial sample collection

surgical repositioning of teeth

transseptal fiberotomy/supra crestal fiberotomy, by report

placement of temporary anchorage device [screw retained plate] requiring flap

placement of temporary anchorage device requiring flap

placement of temporary anchorage device without flap

harvest of bone for use in autogenous grafting procedure

corticotomy — one to three teeth or tooth spaces, per quadrant

corticotomy — four or more teeth or tooth spaces, per quadrant

removal of temporary anchorage device [screw retained plate], requiring flap

removal of temporary anchorage device, requiring flap

removal of temporary anchorage device without flap

alveoloplasty in conjunction with extractions — four or more teeth or tooth spaces, per quadrant

alveoloplasty in conjunction with extractions — one to three teeth or tooth spaces, per quadrant

alveoloplasty not in conjunction with extractions — four or more teeth or tooth spaces, per quadrant

alveoloplasty not in conjunction with extractions — one to three teeth or tooth spaces, per quadrant

vestibuloplasty ridge extension (secondary epithelialization)

vestibuloplasty ridge extension (including soft tissue grafts, muscle reattachment, revision of soft tissue attachment and management hypertrophied and hyperplastic tissue)

excision benign lesion up to 1.25 cm

excision of benign lesion greater than 1.25 cm

excision benign lesion, complicated

excision malignant lesion up to 1.25 cm

excision of malignant lesion greater than 1.25 cm

excision of malignant lesion, complicated

excision of malignant tumor lesion diameter up to 1.25 cm

excision malignant tumor lesion diameter greater than 1.25 cm

removal of benign odontogenic cyst or tumor lesion diameter up to 1.25 cm

removal of benign odontogenic cyst or tumor lesion diameter greater than 1.25 cm

removal of benign nonodontogenic cyst or tumor lesion diameter up to 1.25 cm

removal of benign nonodontogenic cyst or tumor lesion diameter greater than 1.25 cm

destruction of lesion(s) by physical or chemical method, by report

removal of lateral exostosis (maxilla or mandible)

removal of torus palatinus

removal of torus mandibularis

reduction of osseous tuberosity

radical resection of maxilla or mandible

marsupialization of odontogenic cyst

incision and drainage of abscess intraoral soft tissue

incision and drainage of abscess intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)

incision and drainage of abscess extraoral soft tissue

incision and drainage of abscess extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)

removal of foreign body from mucosa, skin, or subcutaneous alveolar tissue

removal of reaction producing foreign bodies, musculoskeletal system

partial ostectomy/sequestrectomy for removal of non-vital bone

maxillary sinusotomy for removal of tooth fragment foreign body

maxilla open reduction (teeth immobilized, if present)

maxilla closed reduction (teeth immobilized, if present)

mandible open reduction (teeth immobilized, if present)

mandible closed reduction (teeth immobilized, if present)

malar and/or zygomatic arch open reduction

malar and/or zygomatic arch closed reduction

alveolus closed reduction, may include stabilization of teeth

alveolus open reduction, may include stabilization of teeth

facial bones complicated reduction with fixation and multiple surgical approaches

maxilla open reduction

maxilla closed reduction

mandible open reduction

mandible closed reduction

malar and/or zygomatic arch open reduction

malar and/or zygomatic arch closed reduction

alveolus open reduction stabilization of teeth

alveolus, closed reduction stabilization of teeth

facial bones complicated reduction with fixation and multiple approaches

open reduction of dislocation

closed reduction of dislocation

manipulation under anesthesia

condylectomy

with/without surgical discectomy, implant

disc repair

synovectomy

myotomy

joint reconstruction

arthrotomy

arthroplasty

arthrocentesis

non-arthroscopic lysis and lavage

arthroscopy diagnosis, with without biopsy or

arthroscopy: lavage and lysis of adhesions

arthroscopy: disc repositioning and stabilization

arthroscopy: synovectomy

arthroscopy: discectomy

arthroscopy: debridement

occlusal orthotic device, by report

occlusal orthotic device adjustment

unspecified TMD therapy, by report

suture recent small wounds up to 5 cm

complicated suture up to 5 cm

complicated suture greater than 5 cm

skin graft (identify defect covered, location and type of graft)

collection and application of autologous blood concentrate product

placement of intra-socket biological dressing to aid in hemostasis or clot stabilization, per site

osteoplasty for orthognathic deformities

osteotomy mandibular rami

osteotomy mandibular rami with bone graft; includes obtaining the graft

osteotomy segmented subapical

osteotomy body of mandible

LeFort I (maxilla)

LeFort I (maxilla segmented)

LeFort II or LeFort III (osteoplasty of facial bones for midface hypoplasia or retrusion) without bone graft

LeFort II or LeFort III with bone graft

osseous, osteoperiosteal, or cartilage graft of the mandible or maxilla autogenous or nonautogenous, by report

sinus augmentation with bone or bone substitutes via lateral open approach

sinus augmentation via vertical approach

bone replacement graft for ridge preservation per site

repair of maxillofacial soft and/or hard tissue defect

guided tissue regeneration, edentulous area — resorbable barrier, per site

guided tissue regeneration, edentulous area — non-resorbable barrier, per site

buccal labial frenectomy (frenulectomy)

lingual frenectomy (frenulectomy)

frenuloplasty

excision of hyperplastic tissue per arch

excision pericoronal gingiva

surgical reduction of fibrous tuberosity

surgical sialolithotomy

surgical sialolithotomy

excision of salivary gland, by report

sialodochoplasty

closure of salivary fistula

emergency tracheotomy

coronoidectomy

surgical placement of craniofacial implant - extra oral

surgical placement: zygomatic implant

synthetic graft mandible facial bones, by report

implant-mandible for augmentation purposes (excluding alveolar ridge), by report

appliance removal (not by dentist who placed appliance), includes removal of archbar

intraoral placement of fixation device not in conjunction with fracture

unspecified oral surgery procedure, by report

Partial extraction for implant

Nerve dissection (by report)

Biopsy minor salivary glands

Indexing for osteotomy

limited orthodontic treatment of the primary dentition

limited orthodontic treatment of the transitional dentition

limited orthodontic treatment of the adolescent dentition

limited orthodontic treatment of the adult dentition

comprehensive orthodontic treatment of the transitional dentition

comprehensive orthodontic treatment of the adolescent dentition

comprehensive orthodontic treatment of the adult dentition

Ortho with orthognathic surgery

removable appliance therapy

fixed appliance therapy

pre-orthodontic treatment examination to monitor growth and development

periodic orthodontic treatment visit

Periodic ortho visit surgery

orthodontic retention (removal of appliances, construction and placement of retainer(s))

removable orthodontic retainer adjustment

removal of fixed orthodontic appliances for other than completion of treatment reasons

repair of orthodontic appliance maxillary

repair of orthodontic appliance mandibular

re-cement or re-bond fixed retainer maxillary

re-cement or re-bond fixed retainer mandibular

repair of fixed retainer, includes reattachment maxillary

repair of fixed retainer, includes reattachment mandibular

replacement of lost or broken retainer maxillary

replacement of lost or broken retainer mandibular

unspecified orthodontic procedure, by report

gingivectomy or gingivoplasty four or more contiguous teeth or tooth bounded spaces per quadrant

gingivectomy or gingivoplasty one to three contiguous teeth or tooth bounded spaces per quadrant

gingivectomy or gingivoplasty to allow for restorative access procedure, per tooth

anatomical crown exposure four or more contiguous teeth or bounded tooth spaces per quadrant

anatomical crown exposure one to three teeth or bounded tooth spaces per quadrant

gingival flap procedure, including root planing four or more contiguous teeth or bounded tooth spaces per quadrant

gingival flap procedure, including root planing one to three contiguous teeth or bounded tooth spaces per quadrant

apically positioned flap

clinical crown lengthening — hard tissue

osseous surgery (including elevation of a full thickness flap and closure) — four or more contiguous teeth or tooth bounded spaces per quadrant

osseous surgery (including elevation of a full thickness flap and closure) — one to three contiguous teeth or tooth bounded spaces per quadrant

bone replacement graft — retained natural tooth — first site in quadrant

bone replacement graft retained natural tooth each additional site in quadrant

biologic materials to aid in soft and osseous tissue regeneration, per site

guided tissue regeneration, natural teeth resorbable barrier, per site

guided tissue regeneration, natural teeth non-resorbable barrier, per site

surgical revision procedure, per tooth

pedicle soft tissue graft procedure

autogenous connective tissue graft procedure (including donor and recipient surgical sites) first tooth, implant or edentulous tooth position in graft

mesial/distal wedge procedure, single tooth (when not performed in conjunction with surgical procedures in the same anatomical area)

non-autogenous connective tissue graft (including recipient site and donor material) first tooth, implant, or edentulous tooth position in graft

combined connective tissue and pedicle graft, per tooth

free soft tissue graft procedure (including recipient and donor surgical sites) first tooth, implant, or edentulous tooth position graft

free soft tissue graft procedure (including recipient and donor surgical sites) each additional contiguous tooth, implant, or edentulous tooth position graft site in conjunction with D4277

autogenous connective tissue graft procedure (including donor and recipient surgical sites) each additional contiguous tooth, implant or edentulous tooth position in same graft site

non-autogenous connective tissue graft procedure (including recipient surgical site and donor material) each additional contiguous tooth, implant or edentulous tooth position in same graft site

removal of non-resorbable barrier

splint intra-coronal; natural teeth or prosthetic crowns

splint extra-coronal; natural teeth or prosthetic crowns

periodontal scaling and root planing four or more teeth per quadrant

periodontal scaling and root planing one to three teeth per quadrant

scaling in presence of generalized moderate or severe gingival inflammation full mouth, after oral evaluation

full mouth debridement to enable comprehensive periodontal evaluation and diagnosis on a subsequent visit

localized delivery of antimicrobial agents via controlled release vehicle into diseased crevicular tissue, per tooth

periodontal maintenance

unscheduled dressing change (by someone other than treating dentist or their staff)

gingival irrigation with medicinal agent per quadrant

unspecified periodontal procedure, by report

prophylaxis adult

prophylaxis child

topical application of fluoride varnish

topical application of fluoride excluding varnish

Immunization counseling

nutritional counseling for control of dental disease

tobacco counseling for the control and prevention of oral disease

counseling for the control and prevention of adverse oral, behavioral, and systemic health effects associated with high-risk substance use

oral hygiene instructions

sealant per tooth

preventive resin restoration in moderate to high caries risk patient permanent tooth

sealant repair per tooth

application of caries arresting medicament per tooth

caries preventive medicament application per tooth

space maintainer fixed, unilateral per quadrant

space maintainer fixed bilateral, maxillary

space maintainer fixed bilateral, mandibular

space maintainer removable, unilateral per quadrant

space maintainer removable bilateral, maxillary

space maintainer removable bilateral, mandibular

re-cement or re-bond bilateral space maintainer maxillary

re-cement or re-bond bilateral space maintainer mandibular

re-cement re-bond unilateral space maintainer per quadrant

removal of fixed unilateral space maintainer per quadrant

removal of fixed bilateral space maintainer maxillary

removal of fixed bilateral space maintainer mandibular

distal shoe space maintainer fixed, unilateral per quadrant

Pfizer-BioNTech Covid-19 vaccine administration first dose

Pfizer-BioNTech Covid-19 vaccine administration second dose

Moderna Covid-19 vaccine administration first dose

Moderna Covid-19 vaccine administration second dose

AstraZeneca Covid-19 vaccine administration first dose

AstraZeneca Covid-19 vaccine administration second dose

Janssen Covid-19 vaccine administration

Pfizer-BioNTech Covid-19 vaccine administration third dose

Pfizer-BioNTech Covid-19 vaccine administration booster dose

Moderna Covid-19 vaccine administration third dose

Moderna Covid-19 vaccine administration booster dose

Janssen Covid-19 vaccine administration booster dose

Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric first dose

Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric second dose

Influenza vaccine

vaccine administration human papillomavirus Dose 1

vaccine administration human papillomavirus Dose 2

vaccine administration human papillomavirus Dose 3

unspecified preventive procedure, by report

amalgam one surface, primary or permanent

amalgam two surfaces, primary or permanent

amalgam three surfaces, primary or permanent

amalgam four or more surfaces, primary or permanent

resin-based composite one surface, anterior

resin-based composite two surfaces, anterior

resin-based composite three surfaces, anterior

Resin-based composite - 4+ surf ant

resin-based composite crown, anterior

resin-based composite two surfaces, posterior

resin-based composite three surfaces, posterior

resin-based composite four or more surfaces, posterior

Add metal substructure to denture

Duplicate denture Max

Duplicate denture Man

pontic indirect resin based composite

pontic cast high noble metal

pontic cast predominantly base metal

pontic cast noble metal

pontic titanium and titanium alloys

pontic porcelain fused to high noble metal

pontic porcelain fused to predominantly base metal

pontic porcelain fused to noble metal

pontic porcelain fused to titanium and titanium alloys

pontic porcelain/ceramic

pontic resin with high noble metal

pontic resin with predominantly base metal

pontic resin with noble metal

interim pontic further treatment or completion of diagnosis necessary prior to final impression

retainer cast metal for resin bonded fixed prosthesis

retainer porcelain/ceramic for resin bonded fixed prosthesis

resin retainer for resin bonded fixed prosthesis

retainer inlay porcelain/ceramic, two surfaces

retainer inlay porcelain/ceramic, three surfaces or more

retainer inlay cast high noble metal, two surfaces

retainer inlay cast high noble metal, three surfaces or more

retainer inlay cast predominantly base metal, two surfaces

retainer inlay cast predominantly base metal, three surfaces or more

retainer inlay cast noble metal, two surfaces

retainer inlay cast noble metal, three surfaces or more

retainer onlay porcelain/ceramic, two surfaces

retainer onlay porcelain/ceramic, three surfaces or more

retainer onlay cast high noble metal, two surfaces

retainer onlay cast high noble metal, three surfaces or more

retainer onlay cast predominantly base metal, two surfaces

retainer onlay cast predominantly base metal, three surfaces or more

retainer onlay cast noble metal, two surfaces

retainer onlay cast noble metal, three surfaces or more

retainer inlay titanium

retainer onlay titanium

retainer indirect resin based composite crown

retainer resin with high noble metal crown

retainer resin with predominantly base metal crown

retainer resin with noble metal crown

retainer porcelain/ceramic crown

retainer crown porcelain fused to high noble metal

retainer crown porcelain fused to predominantly base metal

retainer porcelain fused to noble metal crown

retainer crown porcelain fused to titanium and titanium alloys

retainer cast high noble metal crown

retainer cast predominantly base metal crown

retainer cast noble metal crown

retainer porcelain/ceramic crown

retainer titanium and titanium alloys crown

retainer full cast high noble metal crown

retainer crown full cast predominantly base metal

retainer full cast noble metal crown

interim retainer crown or further treatment completion of diagnosis necessary prior to final impression

retainer titanium and titanium alloys crown

connector bar

re-cement re-bond fixed partial denture

stress breaker

precision attachment

fixed partial denture repair necessitated by restorative material failure

pediatric partial denture, fixed

unspecified fixed prosthodontic procedure, by report

complete denture maxillary

complete denture mandibular

immediate denture maxillary

immediate denture mandibular

maxillary partial denture resin base (including retentive/clasping materials, rests, and teeth)

mandibular partial denture resin base (including retentive/clasping materials, rests, and teeth)

maxillary partial denture cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)

mandibular partial denture cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)

immediate maxillary partial denture resin base (including retentive/clasping materials, rests and teeth)

immediate mandibular partial denture resin base (including retentive/clasping materials, rests and teeth)

immediate maxillary partial denture cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)

immediate mandibular partial denture cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)

maxillary partial denture flexible base (including retentive/clasping materials, rests, and teeth)

mandibular partial denture flexible base (including retentive/clasping materials, rests, and teeth)

immediate maxillary partial denture flexible base (including any clasps, rests and teeth)

immediate mandibular partial denture flexible base (including any clasps, rests and teeth)

removable unilateral partial denture one piece cast metal (including retentive/clasping materials, rests, and teeth), maxillary

removable unilateral partial denture one piece cast metal (including retentive/clasping materials, rests, and teeth), mandibular

removable unilateral partial denture one piece flexible base (including retentive/clasping materials, rests, and teeth) per quadrant

removable unilateral partial denture one piece resin (including retentive/clasping materials, rests, and teeth) per quadrant

adjust complete denture maxillary

adjust complete denture mandibular

adjust partial denture maxillary

adjust partial denture mandibular

repair broken complete denture base, mandibular

repair broken complete denture base, maxillary

Replace teeth complete denture per tooth

repair resin partial denture base, mandibular

repair resin partial denture base, maxillary

repair cast partial framework, mandibular

repair cast partial framework, maxillary

repair replace broken retentive/clasping materials per tooth

Replace teeth partial denture per tooth

Add tooth to existing partial denture

add clasp to existing partial denture per tooth

replace all teeth and acrylic cast metal framework (maxillary)

replace all teeth and acrylic cast metal framework (mandibular)

rebase complete maxillary denture

rebase complete mandibular denture

rebase maxillary partial denture

rebase mandibular partial denture

rebase hybrid prosthesis

reline complete maxillary denture (direct)

reline complete mandibular denture (direct)

reline maxillary partial denture (direct)

reline mandibular partial denture (direct)

reline complete maxillary denture (indirect)

reline complete mandibular denture (indirect)

reline maxillary partial denture (indirect)

reline mandibular partial denture (indirect)

soft liner for complete or partial removable denture indirect

interim complete denture (maxillary)

interim complete denture (mandibular)

interim partial denture (including retentive/clasping materials, rests, and teeth), maxillary

interim partial denture (including retentive/clasping materials, rests, and teeth), mandibular

tissue conditioning, maxillary

tissue conditioning, mandibular

precision attachment, by report

overdenture complete maxillary

overdenture partial maxillary

overdenture complete mandibular

overdenture partial mandibular

replacement of replaceable part of semi-precision precision or attachment, per attachment

modification of removable prosthesis following implant surgery

unspecified removable prosthodontic procedure, by report

Resin-based composite posterior

gold foil one surface

gold foil two surfaces

gold foil three surfaces

inlay metallic one surface

inlay metallic two surfaces

inlay metallic three surfaces or more

onlay metallic two surfaces

onlay metallic three surfaces

onlay metallic four surfaces or more

inlay porcelain/ceramic one surface

inlay porcelain/ceramic two surfaces

inlay porcelain/ceramic three surfaces or more

onlay porcelain/ceramic two surfaces

onlay porcelain/ceramic three surfaces

onlay porcelain/ceramic four surfaces or more

inlay resin-based composite one surface

inlay resin-based composite two surfaces

inlay resin-based composite three surfaces or more

onlay resin-based composite two surfaces

onlay resin-based composite three surfaces

onlay resin-based composite four surfaces or more

resin-based composite (indirect) crown

resin-based composite (indirect) crown

resin with high noble metal crown

resin with predominantly base metal crown

resin with noble metal crown

porcelain/ceramic crown

porcelain fused to high noble metal crown

porcelain fused to predominantly base metal crown

porcelain fused to noble metal crown

porcelain fused to titanium and titanium alloys crown

cast high noble metal crown

cast predominantly base metal crown

cast noble metal crown

porcelain/ceramic crown

full cast high noble metal crown

full cast predominantly base metal crown

full cast noble metal crown

titanium and titanium alloys crown

interim crown

re-cement or re-bond inlay, onlay, partial coverage restoration or veneer

re-cement or re-bond indirectly fabricated or prefabricated post and core

re-cement or re-bond crown

reattachment of tooth fragment, incisal edge or cusp

prefabricated porcelain/ceramic crown — permanent tooth

prefabricated porcelain/ceramic crown — primary tooth

prefabricated stainless steel crown — primary tooth

prefabricated stainless steel crown — permanent tooth

prefabricated resin crown

prefabricated stainless steel crown with resin window

prefabricated esthetic coated stainless steel crown — primary tooth

Placement of interim direct restoration

interim therapeutic restoration — primary dentition

restorative foundation for indirect restoration

core buildup, including any pins when required

pin retention per tooth, in addition to restoration

post and core in addition to crown, indirectly fabricated

each additional indirectly fabricated post same tooth

prefabricated post and core in addition to crown

post removal

Remove indirect restoration

each additional prefabricated post same tooth

labial veneer (resin laminate) direct

labial veneer (resin laminate) indirect

labial veneer (porcelain laminate) indirect

additional procedures to customize a crown to fit under an existing partial denture framework

coping

Band stabilization

Clip - stationary

crown repair necessitated by restorative material failure

inlay repair necessitated by restorative material failure

onlay repair necessitated by restorative material failure

veneer repair necessitated by restorative material failure

Excavation of non-restorable tooth

resin infiltration of incipient smooth surface lesions

Hydroxyapatite regeneration

unspecified restorative procedure, by report

Sleep apnea morning device

Sleep apnea titration visit

Home sleep apnea test

Sleep disorder screening

Unspecified sleep apnea service