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ADA Codes Dental

Clinical Oral Evaluations

D0120 periodic oral evaluation established patient

D0140 limited oral evaluation problem focused

D0145 oral evaluation for a patient under three years of age and counseling with primary caregiver

D0150 comprehensive oral evaluation new or established patient

D0160 detailed and extensive oral evaluation problem focused, by report

D0170 re-evaluation limited, problem focused (established patient; not post-operative visit)

D0180 comprehensive periodontal evaluation new or established patient

Radiographs/Diagnostic Imaging (Including Interpretation)

D0210 intraoral complete series (including bitewings)

D0220 intraoral periapical first film

D0230 intraoral periapical each additional film

D0240 intraoral occlusal film

D0250 extraoral first film

D0260 extraoral each additional film

D0270 bitewing single film D0272 bitewings two films D0273 bitewings three films D0274 bitewings four films

D0277 vertical bitewings 7 to 8 films

D0290 posterior-anterior or lateral skull and facial bone survey film

D0310 sialography

D0320 temporomandibular joint arthrogram, including injection

D0321 other temporomandibular joint films, by report

D0322 tomographic survey D0330 panoramic film D0340 cephalometric film

D0350 oral/facial photographic images

D0360 cone beam ct craniofacial data capture

D0362 cone beam two-dimensional image reconstruction using existing data, includes multiple images

D0363 cone beam three-dimensional image reconstruction using existing data, includes multiple images

Tests and Examinations

D0415 collection of microorganisms for culture and sensitivity

D0416 viral culture

D0417 collection and preparation of saliva sample for laboratory diagnostic testing

D0418 analysis of saliva sample

D0421 genetic test for susceptibility to oral diseases

D0425 caries susceptibility tests

D0431 adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions, not to include cytology or biopsy procedures

D0460 pulp vitality tests

D0470 diagnostic casts

Oral Pathology Laboratory

D0472 accession of tissue, gross examination, preparation and transmission of written report

D0473 accession of tissue, gross and microscopic examination, preparation and transmission of written report

D0474 accession of tissue, gross and microscopic examination, including assessment of surgical margins for presence of disease, preparation and transmission of written report

D0480 accession of exfoliative cytologic smears, microscopic examination, preparation and transmission of written report

D0486 accession of transepithelial cytologic sample, microscopic examination, preparation and transmission of written report

D0475 decalcification procedure

D0476 special stains for microorganisms D0477 special stains, not for microorganisms D0478 immunohistochemical stains

D0479 tissue in-situ hybridization, including interpretation

D0481 electron microscopy diagnostic D0482 direct immunofluorescence D0483 indirect immunofluorescence

D0484 consultation on slides prepared elsewhere

D0485 consultation, including preparation of slides from biopsy material supplied by referring source

D0502 other oral pathology procedures, by report

D0999 unspecified diagnostic procedure, by report

Dental Prophylaxis

D1110 prophylaxis adult

D1120 prophylaxis child

Topical Fluoride Treatment (Office Procedure)

D1203 topical application of fluoride child

D1204 topical application of fluoride adult

D1206 topical fluoride varnish; therapeutic application for moderate to high caries risk patients

Other Preventive Services

D1310 nutritional counseling for control of dental disease

D1320 tobacco counseling for the control and prevention of oral disease

D1330 oral hygiene instructions

D1351 sealant per tooth

D1352 preventive resin restoration in a moderate to high caries risk patient permanent tooth

D1510 space maintainer fixed unilateral

D1515 space maintainer fixed bilateral

D1520 space maintainer removable unilateral D1525 space maintainer removable bilateral D1550 re-cementation of space maintainer

D1555 removal of fixed space maintainer

Amalgam Restorations (Including Polishing)

D2140 amalgam one surface, primary or permanent

D2150 amalgam two surfaces, primary or permanent

D2160 amalgam three surfaces, primary or permanent

D2161 amalgam four or more surfaces, primary or permanent

Resin-based Composite Restorations Direct

D2330 resin-based composite one surface, anterior

D2331 resin-based composite two surfaces, anterior

D2332 resin-based composite three surfaces, anterior

D2335 resin-based composite four or more surfaces or involving incisal angle (anterior)

D2390 resin-based composite crown, anterior

D2391 resin-based composite one surface, posterior

D2392 resin-based composite two surfaces, posterior

D2393 resin-based composite three surfaces, posterior

D2394 resin-based composite four or more surfaces, posterior

Gold Foil Restorations

D2410 gold foil one surface

D2420 gold foil two surfaces

D2430 gold foil three surfaces

Inlay/Onlay Restorations

D2510 inlay metallic one surface

D2520 inlay metallic two surfaces

D2530 inlay metallic three or more surfaces

D2542 onlay metallic two surfaces

D2543 onlay metallic three surfaces

D2544 onlay metallic four or more surfaces

D2610 inlay porcelain/ceramic one surface

D2620 inlay porcelain/ceramic two surfaces

D2630 inlay porcelain/ceramic three or more surfaces

D2642 onlay porcelain/ceramic two surfaces

D2643 onlay porcelain/ceramic three surfaces

D2644 onlay porcelain/ceramic four or more surfaces

D2650 inlay resin-based composite one surface

D2651 inlay resin-based composite two surfaces

D2652 inlay resin-based composite three or more surfaces

D2662 onlay resin-based composite two surfaces

D2663 onlay resin-based composite three surfaces

D2664 onlay resin-based composite four or more surfaces

Crowns - Single Restorations Only

D2710 crown resin-based composite (indirect)

D2712 crown 3⁄4 resin-based composite (indirect)

D2720 crown resin with high noble metal

D2721 crown resin with predominantly base metal

D2722 crown resin with noble metal

D2740 crown porcelain/ceramic substrate

D2750 crown porcelain fused to high noble metal

D2751 crown porcelain fused to predominantly base metal

D2752 crown porcelain fused to noble metal

D2780 crown 3⁄4 cast high noble metal

D2781 crown 3⁄4 cast predominantly base metal

D2782 crown 3⁄4 cast noble metal

D2783 crown 3⁄4 porcelain/ceramic

D2790 crown full cast high noble metal

D2791 crown full cast predominantly base metal

D2792 crown full cast noble metal

D2794 crown titanium

D2799 provisional crown

Other Restorative Services

D2910 recement inlay, onlay, or partial coverage restoration

D2915 recement cast or prefabricated post and core

D2920 recement crown

D2930 prefabricated stainless steel crown primary tooth

D2931 prefabricated stainless steel crown permanent tooth

D2932 prefabricated resin crown

D2933 prefabricated stainless steel crown with resin window

D2934 prefabricated esthetic coated stainless steel crown primary tooth

D2940 protective restoration

D2950 core buildup, including any pins

D2951 pin retention per tooth, in addition to restoration

D2952 post and core in addition to crown, indirectly fabricated

D2953 each additional indirectly fabricated post same tooth

D2954 prefabricated post and core in addition to crown

D2955 post removal (not in conjunction with endodontic therapy)

D2957 each additional prefabricated post same tooth

D2960 labial veneer (resin laminate) chairside

D2961 labial veneer (resin laminate) laboratory

D2962 labial veneer (porcelain laminate) laboratory

D2970 temporary crown (fractured tooth)

D2971 additional procedures to construct new crown under existing partial denture framework

D2975 coping

D2980 crown repair, by report

D2999 unspecified restorative procedure, by report

Pulp Capping

D3110 pulp cap direct (excluding final restoration)

D3120 pulp cap indirect (excluding final restoration)

Pulpotomy

D3220 therapeutic pulpotomy (excluding final restoration) removal of pulp coronal to the dentinocemental junction and application of medicament

D3221 pulpal debridement, primary and permanent teeth

D3222 partial pulpotomy for apexogenesis permanent tooth with incomplete root development

Endodontic Therapy on Primary Teeth

D3230 pulpal therapy (resorbable filling) anterior, primary tooth (excluding final restoration)

D3240 pulpal therapy (resorbable filling) posterior, primary tooth (excluding final restoration)

Endodontic Therapy (Including Treatment Plan, Clinical Procedures and Follow-up Care)

D3310 endodontic therapy, anterior tooth (excluding final restoration)

D3320 endodontic therapy, bicuspid tooth (excluding final restoration)

D3330 endodontic therapy, molar (excluding final restoration)

D3331 treatment of root canal obstruction; non-surgical access

D3332 incomplete endodontic therapy; inoperable, unrestorable or fractured tooth

D3333 internal root repair of perforation defects

Endodontic Retreatment

D3346 retreatment of previous root canal therapy anterior

D3347 retreatment of previous root canal therapy bicuspid

D3348 retreatment of previous root canal therapy molar

Apexification/Recalcification Procedures

D3351 apexification/recalcification/pulpal regeneration initial visit (apical closure/calcific repair of perforations, root resorption, pulp space disinfection, etc.)

D3352 apexification/recalcification/pulpal regeneration interim medication replacement (apical closure/calcific repair of perforations, root resorption, pulp space disinfection, etc.)

D3353 apexification/recalcification final visit (includes completed root canal therapy apical closure/calcific repair of perforations, root resorption, etc.)

D3354 pulpal regeneration (completion of regenerative treatment in an immature permanent tooth with a necrotic pulp); does not include final restoration

Apicoectomy/Periradicular Services

D3410 apicoectomy/periradicular surgery anterior

D3421 apicoectomy/periradicular surgery bicuspid (first root)

D3425 apicoectomy/periradicular surgery molar (first root)

D3426 apicoectomy/periradicular surgery (each additional root)

D3430 retrograde filling per root

D3450 root amputation per root

D3460 endodontic endosseous implant

D3470 intentional reimplantation (including necessary splinting)

Other Endodontic Procedures

D3910 surgical procedure for isolation of tooth with rubber dam

D3920 hemisection (including any root removal), not including root canal therapy

D3950 canal preparation and fitting of preformed dowel or post

D3999 unspecified endodontic procedure, by report

Surgical Services (Including Usual Postoperative Care)

D4210 gingivectomy or gingivoplasty four or more contiguous teeth or tooth bounded spaces per quadrant

D4211 gingivectomy or gingivoplasty one to three contiguous teeth or tooth bounded spaces per quadrant

D4230 anatomical crown exposure four or more contiguous teeth per quadrant

D4231 anatomical crown exposure one to three teeth per quadrant

D4240 gingival flap procedure, including root planing four or more contiguous teeth or tooth bounded spaces per quadrant

D4241 gingival flap procedure, including root planing one to three contiguous teeth or tooth bounded spaces per quadrant

D4245 apically positioned flap

D4249 clinical crown lengthening hard tissue

D4260 osseous surgery (including flap entry and closure) four or more contiguous teeth or tooth bounded spaces per quadrant

D4261 osseous surgery (including flap entry and closure) one to three contiguous teeth or tooth bounded spaces per quadrant

D4263 bone replacement graft first site in quadrant

D4264 bone replacement graft each additional site in quadrant

D4265 biologic materials to aid in soft and osseous tissue regeneration

D4266 guided tissue regeneration resorbable barrier, per site

D4267 guided tissue regeneration nonresorbable barrier, per site (includes membrane removal)

D4268 surgical revision procedure, per tooth

D4270 pedicle soft tissue graft procedure

D4271 free soft tissue graft procedure (including donor site surgery)

D4273 subepithelial connective tissue graft procedures, per tooth

D4274 distal or proximal wedge procedure (when not performed in conjunction with surgical procedures in the same anatomical area)

D4275 soft tissue allograft

D4276 combined connective tissue and double pedicle graft, per tooth

Non-Surgical Periodontal Service

D4320 provisional splinting intracoronal

D4321 provisional splinting extracoronal

D4341 periodontal scaling and root planing four or more teeth per quadrant

D4342 periodontal scaling and root planing one to three teeth per quadrant

D4355 full mouth debridement to enable comprehensive evaluation and diagnosis

D4381 localized delivery of antimicrobial agents via a controlled release vehicle into diseased crevicular tissue, per tooth, by report

Other Periodontal Services

D4910 periodontal maintenance

D4920 unscheduled dressing change (by someone other than treating dentist)

D4999 unspecified periodontal procedure, by report

Complete Dentures (Including Routine Post-Delivery Care)

D5110 complete denture maxillary

D5120 complete denture mandibular

D5130 immediate denture maxillary

D5140 immediate denture mandibular

Partial Dentures (Including Routine Post-delivery Care)

D5211 maxillary partial denture resin base (including any conventional clasps, rests and teeth)

D5212 mandibular partial denture resin base (including any conventional clasps, rests and teeth)

D5213 maxillary partial denture cast metal framework with resin denture bases (including any conventional clasps, rests and teeth)

D5214 mandibular partial denture cast metal framework with resin denture bases (including any conventional clasps, rests and teeth)

D5225 maxillary partial denture flexible base (including any clasps, rests and teeth)

D5226 mandibular partial denture flexible base (including any clasps, rests and teeth)

D5281 removable unilateral partial denture one piece cast metal (including clasps and teeth)

Adjustments to Dentures

D5410 adjust complete denture maxillary

D5411 adjust complete denture mandibular

D5421 adjust partial denture maxillary

D5422 adjust partial denture mandibular

Repairs to Complete Dentures

D5510 repair broken complete denture base

D5520 replace missing or broken teeth complete denture (each tooth)

Repairs to Partial Dentures

D5610 repair resin denture base

D5620 repair cast framework

D5630 repair or replace broken clasp

D5640 replace broken teeth per tooth

D5650 add tooth to existing partial denture

D5660 add clasp to existing partial denture

D5670 replace all teeth and acrylic on cast metal framework (maxillary)

D5671 replace all teeth and acrylic on cast metal framework (mandibular)

Denture Rebase Procedures

D5710 rebase complete maxillary denture

D5711 rebase complete mandibular denture

D5720 rebase maxillary partial denture

D5721 rebase mandibular partial denture

Denture Reline Procedures

D5730 reline complete maxillary denture (chairside)

D5731 reline complete mandibular denture (chairside)

D5740 reline maxillary partial denture (chairside)

D5741 reline mandibular partial denture (chairside)

D5750 reline complete maxillary denture (laboratory)

D5751 reline complete mandibular denture (laboratory)

D5760 reline maxillary partial denture (laboratory)

D5761 reline mandibular partial denture (laboratory)

Interim Prosthesis

D5810 interim complete denture (maxillary)

D5811 interim complete denture (mandibular)

D5820 interim partial denture (maxillary)

D5821 interim partial denture (mandibular)

Other Removable Prosthetic Services

D5850 tissue conditioning, maxillary

D5851 tissue conditioning, mandibular

D5860 overdenture complete, by report

D5861 overdenture partial, by report

D5862 precision attachment, by report

D5867 replacement of replaceable part of semi-precision or precision attachment (male or female component)

D5875 modification of removable prosthesis following implant surgery

D5899 unspecified removable prosthodontic procedure, by report

D5911 facial moulage (sectional) D5912 facial moulage (complete) D5913 nasal prosthesis

D5914 auricular prosthesis D5915 orbital prosthesis D5916 ocular prosthesis D5919 facial prosthesis

D5922 nasal septal prosthesis

D5923 ocular prosthesis, interim

D5924 cranial prosthesis

D5925 facial augmentation implant prosthesis

D5926 nasal prosthesis, replacement

D5927 auricular prosthesis, replacement

D5928 orbital prosthesis, replacement

D5929 facial prosthesis, replacement

D5931 obturator prosthesis, surgical

D5932 obturator prosthesis, definitive

D5933 obturator prosthesis, modification

D5934 mandibular resection prosthesis with guide flange

D5935 mandibular resection prosthesis without guide flange

D5936 obturator prosthesis, interim

D5937 trismus appliance (not for TMD treatment)

D5951 feeding aid

D5952 speech aid prosthesis, pediatric

D5953 speech aid prosthesis, adult

D5954 palatal augmentation prosthesis

D5955 palatal lift prosthesis, definitive

D5958 palatal lift prosthesis, interim

D5959 palatal lift prosthesis, modification

D5960 speech aid prosthesis, modification

D5982 surgical stent

D5983 radiation carrier

D5984 radiation shield

D5985 radiation cone locator

D5986 fluoride gel carrier

D5987 commissure splint

D5988 surgical splint

D5991 topical medicament carrier

D5992 adjust maxillofacial prosthetic appliance, by report

D5993 maintenance and cleaning of a maxillofacial prosthesis (extra or intraoral) other than required adjustments, by report

D5999 unspecified maxillofacial prosthesis, by report

Pre-Surgical Services

D6190 radiographic/surgical implant index, by report

Surgical Services

D6010 surgical placement of implant body: endosteal implant

D6012 surgical placement of interim implant body for transitional prosthesis: endosteal implant

D6040 surgical placement: eposteal implant

D6050 surgical placement: transosteal implant

D6100 implant removal, by report

Implant Supported Prosthetics Supporting Structures

D6055 connecting bar implant supported or abutment supported

D6056 prefabricated abutment includes placement

D6057 custom abutment includes placement

Implant/Abutment Supported Removable Dentures

D6053 implant/abutment supported removable denture for completely edentulous arch

D6054 implant/abutment supported removable denture for partially edentulous arch

Implant /Abutment Supported Fixed Dentures (Hybrid Prosthesis)

D6078 implant/abutment supported fixed denture for completely edentulous arch

D6079 implant/abutment supported fixed denture for partially edentulous arch

Single Crowns, Abutment Supported

D6058 abutment supported porcelain/ceramic crown

D6059 abutment supported porcelain fused to metal crown (high noble metal)

D6060 abutment supported porcelain fused to metal crown (predominantly base metal)

D6061 abutment supported porcelain fused to metal crown (noble metal)

D6062 abutment supported cast metal crown (high noble metal)

D6063 abutment supported cast metal crown (predominantly base metal)

D6064 abutment supported cast metal crown (noble metal)

D6094 abutment supported crown (titanium)

Single Crowns, Implant Supported

D6065 implant supported porcelain/ceramic crown

D6066 implant supported porcelain fused to metal crown (titanium, titanium alloy, high noble metal)

D6067 implant supported metal crown (titanium, titanium alloy, high noble metal)

Fixed Partial Denture, Abutment Supported

D6068 abutment supported retainer for porcelain/ceramic FPD

D6069 abutment supported retainer for porcelain fused to metal FPD (high noble metal)

D6070 abutment supported retainer for porcelain fused to metal FPD (predominantly base metal)

D6071 abutment supported retainer for porcelain fused to metal FPD (noble metal)

D6072 abutment supported retainer for cast metal FPD (high noble metal)

D6073 abutment supported retainer for cast metal FPD (predominantly base metal)

D6074 abutment supported retainer for cast metal FPD (noble metal)

D6194 abutment supported retainer crown for FPD (titanium)

Fixed Partial Denture, Implant Supported

D6075 implant supported retainer for ceramic FPD

D6076 implant supported retainer for porcelain fused to metal FPD (titanium, titanium alloy, or high noble metal)

D6077 implant supported retainer for cast metal FPD (titanium, titanium alloy, or high noble metal)

Other Implant Services

D6080 implant maintenance procedures, including removal of prosthesis, cleansing of prosthesis and abutments and reinsertion of prosthesis

D6090 repair implant supported prosthesis, by report

D6095 repair implant abutment, by report

D6091 replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis, per attachment

D6092 recement implant/abutment supported crown

D6093 recement implant/abutment supported fixed partial denture

D6199 unspecified implant procedure, by report

Fixed Partial Denture Pontics

D6205 pontic indirect resin based composite

D6210 pontic cast high noble metal

D6211 pontic cast predominantly base metal

D6212 pontic cast noble metal

D6214 pontic titanium

D6240 pontic porcelain fused to high noble metal

D6241 pontic porcelain fused to predominantly base metal

D6242 pontic porcelain fused to noble metal

D6245 pontic porcelain/ceramic

D6250 pontic resin with high noble metal

D6251 pontic resin with predominantly base metal

D6252 pontic resin with noble metal

D6253 provisional pontic

D6254 interim pontic

Fixed Partial Denture Retainers Inlays/Onlays

D6545 retainer cast metal for resin bonded fixed prosthesis

D6548 retainer porcelain/ceramic for resin bonded fixed prosthesis

D6600 inlay porcelain/ceramic, two surfaces

D6601 inlay porcelain/ceramic, three or more surfaces

D6602 inlay cast high noble metal, two surfaces

D6603 inlay cast high noble metal, three or more surfaces

D6604 inlay cast predominantly base metal, two surfaces

D6605 inlay cast predominantly base metal, three or more surfaces

D6606 inlay cast noble metal, two surfaces

D6607 inlay cast noble metal, three or more surfaces

D6624 inlay titanium

D6608 onlay porcelain/ceramic, two surfaces

D6609 onlay porcelain/ceramic, three or more surfaces

D6610 onlay cast high noble metal, two surfaces

D6611 onlay cast high noble metal, three or more surfaces

D6612 onlay cast predominantly base metal, two surfaces

D6613 onlay cast predominantly base metal, three or more surfaces

D6614 onlay cast noble metal, two surfaces

D6615 onlay cast noble metal, three or more surfaces

D6634 onlay titanium

Fixed Partial Denture Retainers Crowns

D6710 crown indirect resin based composite

D6720 crown resin with high noble metal

D6721 crown resin with predominantly base metal

D6722 crown resin with noble metal

D6740 crown porcelain/ceramic

D6750 crown porcelain fused to high noble metal

D6751 crown porcelain fused to predominantly base metal

D6752 crown porcelain fused to noble metal

D6780 crown 3⁄4 cast high noble metal

D6781 crown 3⁄4 cast predominantly base metal

D6782 crown 3⁄4 cast noble metal

D6783 crown 3⁄4 porcelain/ceramic

D6790 crown full cast high noble metal

D6791 crown full cast predominantly base metal

D6792 crown full cast noble metal

D6794 crown titanium

D6793 provisional retainer crown

D6795 interim retainer crown

Other Fixed Partial Denture Services

D6920 connector bar

D6930 recement fixed partial denture

D6940 stress breaker

D6950 precision attachment

D6970 post and core in addition to fixed partial denture retainer, indirectly fabricated

D6972 prefabricated post and core in addition to fixed partial denture retainer

D6973 core build up for retainer, including any pins

D6975 coping metal

D6976 each additional indirectly fabricated post same tooth

D6977 each additional prefabricated post same tooth

D6980 fixed partial denture repair, by report

D6985 pediatric partial denture, fixed

D6999 unspecified fixed prosthodontic procedure, by report

Extractions (Includes local anesthesia, suturing, if needed, and routine postoperative care)

D7111 extraction, coronal remnants deciduous tooth

D7140 extraction, erupted tooth or exposed root (elevation and/or forceps removal)

Surgical Extractions (Includes local anesthesia, suturing, if needed, and routing postoperative care)

D7210 surgical removal of erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation of mucoperiosteal flap if indicated

D7220 removal of impacted tooth soft tissue

D7230 removal of impacted tooth partially bony

D7240 removal of impacted tooth completely bony

D7241 removal of impacted tooth completely bony, with unusual surgical complications

D7250 surgical removal of residual tooth roots (cutting procedure)

D7251 coronectomy intentional partial tooth removal

Other Surgical Procedures

D7260 oroantral fistula closure

D7261 primary closure of a sinus perforation

D7270 tooth reimplantation and/or stabilization of accidentally evulsed or displaced tooth

D7272 tooth transplantation (includes reimplantation from one site to another and splinting and/or stabilization)

D7280 surgical access of an unerupted tooth

D7282 mobilization of erupted or malpositioned tooth to aid eruption

D7283 placement of device to facilitate eruption of impacted tooth

D7285 biopsy of oral tissue hard (bone, tooth)

D7286 biopsy of oral tissue soft

D7287 exfoliative cytological sample collection

D7288 brush biopsy transepithelial sample collection

D7290 surgical repositioning of teeth

D7291 transseptal fiberotomy/supra crestal fiberotomy, by report

D7292 surgical placement: temporary anchorage device [screw retained plate] requiring surgical flap

D7293 surgical placement: temporary anchorage device requiring surgical flap

D7294 surgical placement: temporary anchorage device without surgical flap

D7295 harvest of bone fur use in autogenous grafting procedure

Alveoloplasty Surgical Preparation of Ridge for Dentures

D7310 alveoloplasty in conjunction with extractions four or more teeth or tooth spaces, per quadrant

D7311 alveoloplasty in conjunction with extractions one to three teeth or tooth spaces, per quadrant

D7320 alveoloplasty not in conjunction with extractions four or more teeth or tooth spaces, per quadrant

D7321 alveoloplasty not in conjunction with extractions one to three teeth or tooth spaces, per quadrant

Vestibuloplasty

D7340 vestibuloplasty ridge extension (secondary epithelialization)

D7350 vestibuloplasty ridge extension (including soft tissue grafts, muscle reattachment, revision of soft tissue attachment and management of hypertrophied and hyperplastic tissue)

Surgical Excision of Soft Tissue Lesions

D7410 excision of benign lesion up to 1.25 cm

D7411 excision of benign lesion greater than 1.25 cm

D7412 excision of benign lesion, complicated

D7413 excision of malignant lesion up to 1.25 cm

D7414 excision of malignant lesion greater than 1.25 cm

D7415 excision of malignant lesion, complicated

D7465 destruction of lesion(s) by physical or chemical method, by report

Surgical Excision of Intra-osseous Lesions

D7440 excision of malignant tumor lesion diameter up to 1.25 cm

D7441 excision of malignant tumor lesion diameter greater than 1.25 cm

D7450 removal of benign odontogenic cyst or tumor lesion diameter up to 1.25 cm

D7451 removal of benign odontogenic cyst or tumor lesion diameter greater than 1.25 cm

D7460 removal of benign nonodontogenic cyst or tumor lesion diameter up to 1.25 cm

D7461 removal of benign nonodontogenic cyst or tumor lesion diameter greater than 1.25 cm

Excision of Bone Tissue

D7471 removal of lateral exostosis (maxilla or mandible)

D7472 removal of torus palatinus

D7473 removal of torus mandibularis

D7485 surgical reduction of osseous tuberosity

D7490 radical resection of maxilla or mandible

Surgical Incision

D7510 incision and drainage of abscess intraoral soft tissue

D7511 incision and drainage of abscess intraoral soft tissue complicated (includes drainage of multiple fascial spaces)

D7520 incision and drainage of abscess extraoral soft tissue

D7521 incision and drainage of abscess extraoral soft tissue complicated (includes drainage of multiple fascial spaces)

D7530 removal of foreign body from mucosa, skin, or subcutaneous alveolar tissue

D7540 removal of reaction producing foreign bodies, musculoskeletal system

D7550 partial ostectomy/sequestrectomy for removal of non-vital bone

D7560 maxillary sinusotomy for removal of tooth fragment or foreign body

Treatment of Fractures Simple

D7610 maxilla open reduction (teeth immobilized, if present)

D7620 maxilla closed reduction (teeth immobilized, if present)

D7630 mandible open reduction (teeth immobilized, if present)

D7640 mandible closed reduction (teeth immobilized, if present)

D7650 malar and/or zygomatic arch open reduction

D7660 malar and/or zygomatic arch closed reduction

D7670 alveolus closed reduction, may include stabilization of teeth

D7671 alveolus open reduction, may include stabilization of teeth

D7680 facial bones complicated reduction with fixation and multiple surgical approaches

Treatment of Fractures Compound

D7710 maxilla open reduction

D7720 maxilla closed reduction

D7730 mandible open reduction

D7740 mandible closed reduction

D7750 malar and/or zygomatic arch open reduction

D7760 malar and/or zygomatic arch closed reduction

D7770 alveolus open reduction stabilization of teeth

D7771 alveolus, closed reduction stabilization of teeth

D7780 facial bones complicated reduction with fixation and multiple surgical approaches

Reduction of Dislocation and Management of Other Temporomandibular Joint Dysfunctions

D7810 open reduction of dislocation

D7820 closed reduction of dislocation

D7830 manipulation under anesthesia

D7840 condylectomy

D7850 surgical discectomy, with/without implant

D7852 disc repair

D7854 synovectomy

D7856 myotomy

D7858 joint reconstruction

D7860 arthrotomy

D7865 arthroplasty

D7870 arthrocentesis

D7871 non-arthroscopic lysis and lavage

D7872 arthroscopy diagnosis, with or without biopsy

D7873 arthroscopy surgical: lavage and lysis of adhesions

D7874 arthroscopy surgical: disc repositioning and stabilization

D7875 arthroscopy surgical: synovectomy

D7876 arthroscopy surgical: discectomy

D7877 arthroscopy surgical: debridement

D7880 occlusal orthotic device, by report

D7899 unspecified TMD therapy, by report

Repair of Traumatic Wounds

D7910 suture of recent small wounds up to 5 cm

Complicated Suturing (Reconstruction Requiring Delicate Handling of Tissues and Wide Undermining for Meticulous Closure)

D7911 complicated suture up to 5 cm

D7912 complicated suture greater than 5 cm

Other Repair Procedures

D7920 skin graft (identify defect covered, location and type of graft)

D7940 osteoplasty for orthognathic deformities

D7941 osteotomy mandibular rami

D7943 osteotomy mandibular rami with bone graft; includes obtaining the graft

D7944 osteotomy segmented or subapical

D7945 osteotomy body of mandible

D7946 LeFort I (maxilla total)

D7947 LeFort I (maxilla segmented)

D7948 LeFort II or LeFort III (osteoplasty of facial bones for midface hypoplasia or retrusion)-without bone graft

D7949 LeFort II or LeFort III with bone graft

D7950 osseous, osteoperiosteal, or cartilage graft of the mandible or maxilla autogenous or nonautogenous, by report

D7951 sinus augmentation with bone or bone substitutes

D7953 bone replacement graft for ridge preservation per site

D7955 repair of maxillofacial soft and/or hard tissue defect

D7960 frenulectomy also known as frenectomy or frenotomy separate procedure not incidental to another procedure

D7963 frenuloplasty

D7970 excision of hyperplastic tissue per arch

D7971 excision of pericoronal gingiva

D7972 surgical reduction of fibrous tuberosity

D7980 sialolithotomy

D7981 excision of salivary gland, by report

D7982 sialodochoplasty

D7983 closure of salivary fistula

D7990 emergency tracheotomy

D7991 coronoidectomy

D7995 synthetic graft mandible or facial bones, by report

D7996 implant-mandible for augmentation purposes (excluding alveolar ridge), by report

D7997 appliance removal (not by dentist who placed appliance), includes removal of archbar

D7998 intraoral placement of a fixation device not in conjunction with a fracture

D7999 unspecified oral surgery procedure, by report

Limited Orthodontic Treatment

D8010 limited orthodontic treatment of the primary dentition

D8020 limited orthodontic treatment of the transitional dentition

D8030 limited orthodontic treatment of the adolescent dentition

D8040 limited orthodontic treatment of the adult dentition

Interceptive Orthodontic Treatment

D8050 interceptive orthodontic treatment of the primary dentition

D8060 interceptive orthodontic treatment of the transitional dentition

Comprehensive Orthodontic

D8070 comprehensive orthodontic treatment of the transitional dentition

D8080 comprehensive orthodontic treatment of the adolescent dentition

D8090 comprehensive orthodontic treatment of the adult dentition

Minor Treatment to Control Harmful Habits

D8210 removable appliance therapy

D8220 fixed appliance therapy

Other Orthodontic Services

D8660 pre-orthodontic treatment visit

D8670 periodic orthodontic treatment visit (as part of contract)

D8680 orthodontic retention (removal of appliances, construction and placement of retainer(s))

D8690 orthodontic treatment (alternative billing to a contract fee)

D8691 repair of orthodontic appliance

D8692 replacement of lost or broken retainer

D8693 rebonding or recementing; and/or repair, as required, of fixed retainers

D8999 unspecified orthodontic procedure, by report

Unclassified Treatment

D9110 palliative (emergency) treatment of dental pain minor procedure

D9120 fixed partial denture sectioning

Anesthesia

D9210 local anesthesia not in conjunction with operative or surgical procedures

D9211 regional block anesthesia

D9212 trigeminal division block anesthesia

D9215 local anesthesia in conjunction with operative or surgical procedures

D9220 deep sedation/general anesthesia first 30 minutes

D9221 deep sedation/general anesthesia each additional 15 minutes

D9230 inhalation of nitrous oxide/anxiolysis, analgesia

D9241 intravenous conscious sedation/analgesia first 30 minutes

D9242 intravenous conscious sedation/analgesia each additional 15 minutes

D9248 non-intravenous conscious sedation

Professional Consultation

D9310 consultation diagnostic service provided by dentist or physician other than requesting dentist or physician

Professional Visits

D9410 house/extended care facility call

D9420 hospital or ambulatory surgical center call

D9430 office visit for observation (during regularly scheduled hours) no other services performed

D9440 office visit after regularly scheduled hours

D9450 case presentation, detailed and extensive treatment planning

Drugs

D9610 therapeutic parenteral drug, single administration

D9612 therapeutic parenteral drugs, two or more administrations, different medications

D9630 other drugs and/or medicaments, by report

Miscellaneous Services

D9910 application of desensitizing medicament

D9911 application of desensitizing resin for cervical and/or root surface, per tooth

D9920 behavior management, by report

D9930 treatment of complications (post-surgical) unusual circumstances, by report

D9940 occlusal guard, by report

D9941 fabrication of athletic mouthguard

D9942 repair and/or reline of occlusal guard

D9950 occlusion analysis mounted case

D9951 occlusal adjustment limited

D9952 occlusal adjustment complete

D9970 enamel microabrasion

D9971 odontoplasty 1-2 teeth; includes removal of enamel projections

D9972 external bleaching per arch

D9973 external bleaching per tooth

D9974 internal bleaching per tooth

D9999 unspecified adjunctive procedure, by report

 

 
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