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codes.csv
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7542 lines (7542 loc) · 379 KB
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8025 054 Handling fee - direct materials
8101 054 Oral examination
8102 054 Comprehensive oral examination
8104 054 Limited oral examination
8106 054 Special report
8107 054 Intraoral radiograph - periapical
8108 054 Intraoral radiographs - complete series
8109 054 Infection control/barrier techniques
8110 054 Sterilized instrumentation
8112 054 Intraoral radiograph - bitewing
8113 054 Intraoral radiograph - occlusal
8114 054 Extraoral radiograph - hand-wrist
8115 054 Extraoral radiograph - panoramic
8116 054 Extraoral radiograph - cephalometric
8117 054 Diagnostic models
8118 054 Extraoral radiograph - skull/facial bone
8119 054 Diagnostic models mounted
8120 054 Treatment plan completed
8121 054 Oral and/or facial image
8123 054 Caries susceptibility tests (by arrangement)
8124 054 Pulp tests
8129 054 Office/hospital visit - after regularly scheduled hours
8131 054 Emergency dental treatment
8132 054 Pulp removal (pulpectomy)
8133 054 Recement inlay, onlay, crown or veneer
8135 054 Remove inlay, onlay or crown
8136 054 Access through a prosthetic crown or inlay to facilitate root canal treatment
8137 054 Emergency crown (chair-side)
8138 054 Remove retention post (prefabricated or cast)
8139 054 Appointment not kept /30min
8140 054 House/extended care facility/hospital call
8141 054 Inhalation sedation - first 15 minutes or part thereof
8143 054 Inhalation sedation - each addnl 15 minutes
8144 054 Intravenous sedation
8145 054 Local anaesthetic - per visit
8146 054 Resin bonding for restorations
8147 054 Monitoring equipment for intravenous sedation
8151 054 Oral hygiene instruction
8153 054 Oral hygiene instruction - each additional visit
8154 054 Oral examination - oral hygienist
8155 054 Polishing - complete dentition
8157 054 Re-burnishing and polishing of restorations – complete dentition
8158 054 Enamel microabrasion
8159 054 Prophylaxis - complete dentition
8160 054 Removal of gross calculus
8161 054 Topical application of fluoride - child
8162 054 Topical application of fluoride - adult
8163 054 Dental sealant
8164 054 Limited oral examination - oral hygienist
8165 054 Sedative filling
8166 054 Application of desensitising resin, per tooth
8167 054 Application of desensitising medicament, per visit
8169 054 Occlusal guard
8171 054 Mouth protector
8172 054 Cost of orthotic appliance
8173 054 Space maintainer - fixed, per abutment
8175 054 Space maintainer - removable
8176 054 Periodontal screening
8177 054 Oral hygiene instruction (periodontally compromised patient)
8178 054 Oral hygiene instruction - each additional visit (periodontally compromised patient)
8179 054 Polishing - complete dentition (periodontally compromised patient)
8180 054 Prophylaxis - complete dentition (periodontally compromised patient)
8183 054 Therapeutic drug injection
8189 054 Re-examination - existing condition
8190 054 Consultation - second opinion or advice
8192 054 Suture - minor
8194 054 Cbct capture and interpretation with limited field of view - less than one whole jaw
8195 054 Cbct capture and interpretation with limited field of view of one full arch - mandible
8196 054 Cbct capture and interpretation with limited field of view of one full arch - maxilla without orbits and/or cranium
8197 054 Cbct capture and interpretation with limited field of view of both dental arches – without orbits and/or cranium
8198 054 Cbct capture and interpretation for tmj series including two or more exposures
8199 054 Cbct capture and interpretation with limited field of view of one full arch - maxilla with orbits and/or cranium
8200 054 Cbct capture and interpretation with field of view of both dental arches - with orbits and/or cranium
8201 054 Extraction - tooth or exposed tooth roots (first per quadrant)
8202 054 Extraction - each additional tooth or exposed tooth roots
8213 054 Surgical removal of residual roots, first tooth per quadrant
8214 054 Surgical removal of residual roots, second and subsequent teeth''s roots
8220 054 Cost of suture material
8228 054 Art restorations
8231 054 Complete dentures - maxillary and mandibular
8232 054 Complete denture - maxillary or mandibular
8233 054 Partial denture - resin base - one tooth
8234 054 Partial denture - resin base - two teeth
8235 054 Partial denture - resin base - three teeth
8236 054 Partial denture - resin base - four teeth
8237 054 Partial denture - resin base - five teeth
8238 054 Partial denture - resin base - six teeth
8239 054 Partial denture - resin base - seven teeth
8240 054 Partial denture - resin base - eight teeth
8241 054 Partial denture - resin base - nine or more teeth
8244 054 Immediate denture - maxillary
8245 054 Immediate denture - mandibular
8251 054 Clasp or rest - cast gold
8253 054 Clasp or rest - wrought gold
8255 054 Clasp or rest - stainless steel
8257 054 Bar - lingual or palatal
8259 054 Rebase complete or partial denture
8261 054 Remodel complete or partial denture
8263 054 Reline complete or partial denture (chair-side)
8265 054 Tissues conditioning per arch (including soft self-cure reline)
8267 054 Reline complete or partial denture
8269 054 Repair denture or other intra-oral appliance
8270 054 Add clasp to existing partial denture
8271 054 Add tooth to existing partial denture
8273 054 Impression to repair or modify a denture or other intra-oral appliance
8275 054 Adjust complete or partial denture
8277 054 Inlay in denture
8281 054 Partial denture - cast metal framework only
8301 054 Pulp cap - direct
8303 054 Pulp cap - indirect
8304 054 Rubber dam per arch
8306 054 Cost of mta
8307 054 Pulp amputation (pulpotomy)
8310 054 Supply of bleaching materials
8325 054 Internal bleaching - per tooth
8327 054 Internal bleaching - each additional visit
8328 054 Root canal obturation - anteriors and premolars - each additional canal
8329 054 Root canal therapy - anteriors and premolars – each additional canal
8330 054 Removal of root canal obstruction
8332 054 Root canal preparatory visit - single canal tooth
8333 054 Root canal preparatory visit - multi canal
8334 054 Re-treatment of previously completed root canal therapy, per canal
8335 054 Root canal obturation - anteriors and premolars - first canal
8336 054 Root canal obturation - posteriors - first canal
8337 054 Root canal obturation - posteriors – each additional canal
8338 054 Root canal therapy - anteriors and premolars – first canal
8339 054 Root canal therapy - posteriors - first canal
8340 054 Root canal therapy - posteriors – each additional canal
8341 054 Amalgam - one surface
8342 054 Amalgam - two surfaces
8343 054 Amalgam - three surfaces
8344 054 Amalgam - four or more surfaces
8345 054 Prefabricated post retention, per post (in addition to restoration)
8347 054 Pin retention - first pin (in addition to restoration)
8348 054 Pin retention - each additional pin (in addition to restoration)
8349 054 Carve restoration to accommodate existing removable prosthesis
8350 054 Resin crown - anterior primary tooth (direct)
8351 054 Resin - one surface, anterior
8352 054 Resin - two surfaces, anterior
8353 054 Resin - three surfaces, anterior
8354 054 Resin - four or more surfaces, anterior
8355 054 Veneer - resin (chair-side)
8357 054 Prefabricated metal crown
8361 054 Inlay - metal - one surface
8362 054 Inlay/onlay - metal - two surfaces
8363 054 Inlay/onlay - metal - three surfaces
8364 054 Inlay/onlay - metal - four or more surfaces
8366 054 Pin retention as part of cast restoration (any number of pins)
8367 054 Resin - one surface, posterior
8368 054 Resin - two surfaces, posterior
8369 054 Resin - three surfaces, posterior
8370 054 Resin - four or more surfaces, posterior
8371 054 Inlay - porcelain - one surface
8372 054 Inlay/onlay - porcelain - two surfaces
8373 054 Inlay/onlay - porcelain - three surfaces
8374 054 Inlay/onlay - porcelain - four or more surfaces
8375 054 Prefabricated resin crown
8376 054 Core build-up with prefabricated posts
8379 054 Cost of prefabricated posts
8381 054 Inlay - resin - one surface
8382 054 Inlay/onlay - resin - two surfaces
8383 054 Inlay/onlay - resin - three surfaces
8384 054 Inlay/onlay - resin - four or more surfaces
8391 054 Cast core with single post
8392 054 Cast post (each additional)
8397 054 Cast core with pins (any number of pins)
8398 054 Core build-up with pins
8401 054 Crown - full cast metal
8403 054 Crown - 3/4 cast metal
8404 054 Crown - 3/4 porcelain/ceramic
8405 054 Crown - resin laboratory
8407 054 Crown - resin with metal
8409 054 Crown - porcelain/ceramic
8410 054 Provisional crown
8411 054 Crown - porcelain veneered to metal
8413 054 Repair crown (permanent or provisional)
8414 054 Additional fee for provision of crown within an existing clasp or rest
8415 054 Pontic - ceramic
8416 054 Pontic - cast metal
8417 054 Pontic - resin with metal
8418 054 Pontic - porcelain veneered to metal
8419 054 Provisional pontic
8432 054 Inlay/onlay retainer - metal - two surfaces
8433 054 Inlay/onlay retainer - metal - three surfaces
8434 054 Inlay/onlay retainer - metal - four or more surfaces
8436 054 Inlay/onlay retainer - porcelain - two surfaces
8437 054 Inlay/onlay retainer - porcelain - three
8438 054 Inlay/onlay retainer - porcelain - four or more surfaces
8441 054 Crown retainer - full cast metal
8442 054 Crown retainer - 3/4 cast metal
8443 054 Crown retainer - ceramic
8444 054 Crown retainer - 3/4 ceramic
8445 054 Crown retainer - porcelain veneered to metal
8446 054 Crown retainer - resin with metal
8447 054 Provisional crown retainer
8499 054 General anaesthetic
8501 054 Consultation - prosthodontis
8503 054 Occlusion analysis mounted
8505 054 Pantographic recording
8506 054 Detailed consultation - prosthodontist
8507 054 Comprehensive consultation - prosthodontist
8508 054 Electrognathographic recording
8509 054 Electrognathographic recording with computer analysis
8514 054 Recement bridge
8516 054 Remove bridge
8517 054 Reimplantation of avulsed tooth (include stabilisation)
8518 054 Repair bridge
8533 054 Implant supported removable complete overdenture
8534 054 Implant supported removable partial overdenture
8536 054 Crown-implant/abutment supported crown – porcelain/ceramic
8537 054 Crown-implant/abutment supported crown – porcelain with metal
8538 054 Crown-implant/abutment supported crown – cast metal
8546 054 Implant supported crown retainer - ceramic
8547 054 Implant supported crown retainer – porcelain veneered to metal
8548 054 Crown retainer - implant/abutment supported – cast metal
8551 054 Occlusal adjustment - major
8552 054 Veneer - porcelain (laboratory)
8553 054 Occlusal adjustment - minor
8554 054 Veneer - resin (laboratory)
8560 054 Cost of ceramic block
8561 054 Gold foil class i or iv
8563 054 Gold foil class v
8565 054 Gold foil class iii
8570 054 Fabrication of computer generated ceramic restoration
8578 054 Prefabricated abutment
8579 054 Custom abutment
8580 054 Customised prefabricated abutment
8581 054 Cast core with single post
8582 054 Cast core with double post
8583 054 Cast core with triple post
8584 054 Connector bar - implant supported
8585 054 Connector bar
8586 054 Stress breaker
8587 054 Coping metal
8590 054 Implant maintenance procedures - per implant
8592 054 Crown - implant/abutment supported
8594 054 Repair of implant supported prosthesis
8595 054 Repair of implant abutment
8597 054 Locks and milled rests
8599 054 Precision attachment (removable denture)
8600 054 Cost of implant components
8611 054 Pontic - sanitary
8613 054 Pontic - posterior
8615 054 Pontic - anterior/premolar
8617 054 Retainer cast metal (maryland type retainer)
8631 054 Root canal therapy - first canal specialist prosthodontist
8633 054 Root canal therapy - each additional canal specialist prosthodontist
8635 054 Pexific tion/ pexogenesis/rec lcific tion – per visit
8640 054 Removal of fractured root canal instrument
8643 054 Complete dentures - maxillary and mandibular. Only for prosthodontists
8645 054 Complete dentures - maxillary or mandibular. Only for prosthodontists
8649 054 Immediate denture - maxillary. Only for prosthodontist
8651 054 Immediate denture - mandibular. Only for prosthodontist
8652 054 Overdenture - complete
8653 054 Overdenture - partial
8654 054 Implant supported fixed-detachable complete overdenture
8655 054 Implant supported fixed-detachable partial overdenture
8657 054 Replacement of precision attachment
8658 054 Interim complete denture
8659 054 Interim partial denture
8660 054 Additional fee to implant supported fixed- detachable denture - per implant
8661 054 Diagnostic dentures (including tissue conditioning)
8662 054 Adjust complete or partial dentures (remounting)
8663 054 Metal base to complete denture
8664 054 Remount crown or bridge for adjustment
8667 054 Soft base to denture (heat cured)
8671 054 Partial denture - cast metal framework with resin denture base
8672 054 Altered cast technique (in addition to partial denture)
8674 054 Additive partial denture
8701 054 Consultation - periodontist
8703 054 Consultation - periodontist (detailed)
8705 054 Re-examination - periodontist
8707 054 Periodontal screening - periodontist
8723 054 Provisional splinting - extracoronal (wire) – per sextant
8725 054 Provisional splinting - extracoronal (wire plus resin) - per sextant
8727 054 Provisional splinting - intracoronal - per tooth
8731 054 Incision & drainage of abscess - intra-oral
8737 054 Root planing - four or more teeth per
8739 054 Root planing - one to three teeth per quadrant
8741 054 Gingivectomy/gingivoplasty - four or more teeth per quadrant
8743 054 Gingivectomy or gingivoplasty - one to three teeth per quadrant
8749 054 Flap procedure, root planing and one to three surgical services - per quadrant
8751 054 Flap procedure, root planing and one to three surgical services - per sextant
8753 054 Flap procedure, root planing and four or more surgical services - per quadrant
8755 054 Flap procedure, root planing and four or more surgical services - per sextant
8756 054 Clinical crown lengthening (isolated procedure)
8759 054 Pedicle flapped graft (isolated procedure)
8761 054 Masticatory mucosal autograft - one to four teeth (isolated procedure)
8762 054 Masticatory mucosal autograft - four or more teeth (isolated procedure)
8763 054 Wedge resection (isolated procedure)
8765 054 Hemisection of a tooth, resection of a root or tunnel preparation (isolated procedure)
8766 054 Bone regeneration/repair procedure - as part of a flap operation
8767 054 Bone regeneration/repair procedure - at a single site
8768 054 Unlisted periodontal procedure
8769 054 Membrane removal (used for guided tissue regeneration)
8770 054 Cost of bone regenerative/repair material
8772 054 Submucosal connective tissue autograft (isolated procedure)
8773 054 Cost of intrapocket chemotherapeutic agent
8781 054 Consultation - oral medicine (simple)
8782 054 Consultation - oral medicine (complex)
8783 054 Consultation - oral medicine (subsequent)
8787 054 Unlisted oral medicine procedure
8801 054 Consultation - orthodontist
8803 054 Consultation - orthodontis (subsequent, retention and post treatment)
8811 054 Tracing and analysis of extra-oral film
8837 054 Diagnosis and treatment planning – orthodontist
8839 054 Diagnostic setup
8840 054 Treatment planning for orthognathic surgery – all
8841 054 Ortho tx - fixed lingual appliance - one arch
8842 054 Ortho tx - fixed lingual appliance - one arch, modeate
8843 054 Ortho tx - fixed lingual appliance - one arch, severe
8846 054 Repair orthodontic appliance - removable
8847 054 Replace orthodontic appliance - removable
8848 054 Repair orthodontic appliance - fixed
8849 054 Retainer (orthodontic)
8850 054 Treatment of mpds - first visit
8851 054 Treatment of mpds - subsequent visit
8852 054 Occlusal orthotic appliance
8855 054 Consultation - cleft palate therapy (house or hospital)
8856 054 Consultation - cleft palate (subsequent)
8857 054 Consultation - cleft palate (maximum)
8858 054 Ortho tx - functional appliance
8861 054 Ortho tx - partial fixed appliance - minor
8862 054 Ortho tx - removable appliance
8863 054 Ortho tx - each additional removable appliance
8865 054 Ortho tx - partial fixed appliance - one arch
8866 054 Ortho tx - partial fixed appliance - both arches
8867 054 Ortho tx - fixed appliance - one arch
8868 054 Ortho tx - fixed appliance - one arch, moderate
8869 054 Ortho tx - fixed appliance - one arch, severe
8873 054 Ortho tx - fixed appliance - both arches, class 1 mild
8874 054 Ortho tx - fixed lingual appliance - both arches, class 1 mild
8875 054 Ortho tx - fixed appliance - both arches, class 1 moderate
8876 054 Ortho tx - fixed lingual appliance - both arches, class 1 moderate
8877 054 Ortho tx - fixed appliance - both arches, class 1 severe
8878 054 Ortho tx - fixed lingual appliance - both arches, class 1 severe
8879 054 Ortho tx - fixed appliance - both arches, class 1 severe w/ complications
8880 054 Ortho tx - fixed lingual appliance - both arches, class 1 severe w/ complications
8881 054 Ortho tx - fixed appliance - both arches, class 2/3 mild
8882 054 Ortho tx - fixed lingual appliance - both arches, class 2/3 mild
8883 054 Ortho tx - fixed appliance - both arches, class 2/3 moderate
8884 054 Ortho tx - fixed lingual appliance - both arches, class 2/3 moderate
8885 054 Ortho tx - fixed appliance - both arches, class 2/3 severe
8886 054 Ortho tx - fixed lingual appliance - both arches, class 2/3 severe
8887 054 Ortho tx - fixed appliance - both arches, class 2/3 severe w/ complications
8888 054 Ortho tx - fixed lingual appliance - both arches, class 2/3 severe w/ complications
8890 054 Monthly instalment ortho tx
8891 054 Orthodontic transfer
8892 054 Orthodontic re-treatment
8901 054 Consultation - mfos
8902 054 Consultation - mfos (detailed)
8903 054 House/hosp/nursing home consultation - mfos
8904 054 House/hosp/nursing home consultation (subsequent) - mfos
8905 054 After regularly hours consultation - mfos
8907 054 House/hosp/nursing home consultation (maximum per week) - mfos
8908 054 Surgical removal of roots from maxillary antrum
8909 054 Oral antral fistula closure
8911 054 Caldwell-luc procedure
8917 054 Biopsy of oral tissue - soft
8919 054 Biopsy of bone - needle
8921 054 Biopsy - extr -or l bone/soft tissue
8931 054 Treatment of post-extraction haemorrhage
8933 054 Treatment of haemorrhage (blood dyscracias)
8935 054 Treatment of septic socket
8937 054 Surgical removal of tooth
8941 054 Surgical removal of impacted tooth – first tooth
8943 054 Surgical removal of impacted tooth – second tooth
8945 054 Surgical removal of impacted tooth - third and subsequent teeth
8953 054 Surgical removal of residual roots, first tooth - per tooth
8957 054 Alveolotomy or alveolectomy (including extractions)
8958 054 Emergency tracheotomy
8959 054 Pharyngostomy
8961 054 Tooth transplantation
8962 054 Harvest iliac crest graft
8963 054 Harvest rib graft
8964 054 Harvest cranium graft
8965 054 Peripheral neurectomy
8966 054 Repair of oronasal fistula (local flaps)
8967 054 Surgical removal of jaw cyst – intra-oral approach
8969 054 Surgical removal of jaw cyst – extra-oral approach
8971 054 Excision of tumour of the soft tissue
8973 054 Surgical excision of tumours of the jaw
8975 054 Hemiresection of jaw excluding condyl
8977 054 Surgical repair of maxilla or mandible - major
8979 054 Harvesting of autogenous grafts (intra-oral)
8981 054 Surgical exposure of impacted or unerupted teeth to aid eruption
8983 054 Corticotomy - first tooth
8984 054 Corticotomy - each additional tooth
8985 054 Frenulectomy/frenulotomy
8987 054 Reduction of mylohyoid ridges - per side
8989 054 Removal torus mandibularis
8991 054 Removal of torus palatinus
8993 054 Surgical reduction of osseous tuberosity – per side
8995 054 Gingivectomy - per jaw
8997 054 Sulcoplasty / vestibuloplasty
9003 054 Reposition mental foramen and nerve - per side
9004 054 Lateralization of inferior dental nerve
9005 054 Alveolar ridge augmentation - total (by bone graft)
9007 054 Alveolar ridge augmentation - total (by alloplastic material)
9008 054 Alveolar ridge augmentation - one to two tooth sites
9009 054 Alveolar ridge augmentation - three across 3 or more tooth sites
9010 054 Sinus lift procedure
9011 054 Incision & drainage of abscess – intra-oral (pyogenic)
9013 054 Incision & drainage of abscess – extra-oral (pyogenic)
9015 054 Apicectomy/periradicular surgery – anteriors (including retrograde filling)
9016 054 Apicectomy/periradicular surgery – molars (including retrograde filling)
9017 054 Decortication, saucerisation and sequestrectomy
9019 054 Sequestrectomy - intra oral per sextant and or ramus
9021 054 Suture - reconstruction, minor (excludes closure of surgical incisions)
9023 054 Closure of surgical incisions)
9024 054 Dento-alveolar fracture - per sextant
9025 054 Mandible fracture - closed reduction
9027 054 Mandible fracture - compound, with eyelet wiring
9029 054 Mandible fracture - splints
9031 054 Mandible fracture - open reduction
9032 054 Reduction of masseter muscle and bone – extra- oral approach
9033 054 Open treatment of condylar fracture
9035 054 Maxilla fracture - le fort i or guerin
9036 054 Open treatment of maxillary fracture - le fort i
9037 054 Maxilla fracture - le fort ii or middle third face
9038 054 Open treatment of maxillary fracture - le fort ii middle third of face
9039 054 Maxilla fracture - le fort iii or craniofacial disjunction
9041 054 Zygomatic arch fracture - closed reduction
9043 054 Zygomatic arch fracture - open reduction
9045 054 Zygomatic arch fracture - open reduction (requiring osteosynthesis and/or grafting)
9046 054 Placement of zygomaticus fixture, per fixture
9047 054 Osteotomy - open with stabilisation
9048 054 Surgical removal of internal fixation devices, per site
9049 054 Osteotomy - mandible body, anterior
9050 054 Osteotomy - total subapical
9051 054 Genioplasty
9052 054 Midfacial exposure
9053 054 Coronoidectomy (intra-oral approach)
9055 054 Osteotomy - segmented, posterior
9057 054 Osteotomy - segmented, anterior
9059 054 Reconstruct maxilla - le fort i osteotomy, one piece
9060 054 Reconstruct maxilla - le fort i osteotomy w/ repositioning and graft
9061 054 Palatal osteotomy
9062 054 Reconstruct maxilla - le fort i osteotomy, multiple segments
9063 054 Reconstruct maxilla - le fort 2 osteotomy (facial and post-traumatic deformities)
9065 054 Reconstruct maxilla - le fort 3 osteotomy (severe congenital deformities)
9066 054 Surgical expansion - maxilliary or mandibular
9067 054 Distraction osteogenesis - across one to two tooth sites
9068 054 Distraction osteogenesis - across three to five tooth sites
9069 054 Glossectomy - partial
9070 054 Distraction osteogenesis - full arch
9071 054 Geniohyoidotomy
9072 054 Close secondary oro-nasal fistula w/ bone grafting (complete procedure)
9074 054 Tmj arthroscopy diagnostic
9075 054 Condylectomy, coronoidectomy or both
9076 054 Tmj artrocentesis
9077 054 Tmj intra-articular injection
9079 054 Trigger point injection
9081 054 Condylectomy (ward/kostecka)
9083 054 Tmj srthroplasty
9085 054 Reduction of tmj disloc w/o anaesthetic
9087 054 Reduction of tmj disloc w/ anaesthetic
9089 054 Reduction of tmj disloc w/ anaesthetic and immobobilisation
9091 054 Reduction of tmj dislocation - open reduction
9092 054 Joint reconstruction
9093 054 Removal of salivary stone (sialolithotomy)
9095 054 Excision of sublinglual salivary gland
9096 054 Excision of salivary gland - extra oral
9099 054 Unlisted dental procedure or service (by
9101 054 Obturator prosthesis, surgical – modified denture
9102 054 Obturator prosthesis, surgical – continuous base
9103 054 Obturator prosthesis, surgical - split base
9104 054 Obturator prosthesis, interim - on existing denture
9105 054 Obturator prosthesis, interim - on new denture
9106 054 Obturator prosthesis, definitive – open/hollow box
9107 054 Obturator prosthesis, definitive - silicone glove
9108 054 Mandibular resection prosthesis w/ guide flange
9109 054 Mandibular resection prosthesis w/o guide flange
9110 054 Mandibular resection prosthesis, palatal augmentation
9111 054 Glossal resection prosthesis - simple
9112 054 Glossal resection prosthesis - complex
9113 054 Radiation carrier - simple
9114 054 Radiation carrier - complex
9115 054 Radiation shield - simple
9116 054 Radiation shield - complex
9117 054 Radiation cone locator
9118 054 Chemotherapeutic agent carrier
9119 054 Feeding aid prosthesis, neonatal
9120 054 Orthopaedic appliance, active presurgical – minor
9121 054 Orthopaedic appliance, active presurgical – moderate
9122 054 Orthopaedic appliance, active presurgical – severe
9123 054 Orthopaedic appliance, active presurgical – modification
9125 054 Speech aid/obturator prosthesis – palatal alteration
9126 054 Speech aid/obturator prosthesis – velar alteration
9127 054 Speech aid/obturator prosthesis – pharyngeal alteration
9128 054 Speech aid/obturator prosthesis - modification
9129 054 Speech aid/obturator prosthesis - surgical
9130 054 Speech aid appliance - palatal lift
9131 054 Speech aid appliance - palatal stimulating
9132 054 Speech aid appliance - bulb
9133 054 Speech aid appliance - modification
9134 054 Unspecified speech aid appliance
9135 054 Auricular prosthesis - simple
9136 054 Auricular prosthesis - complex
9137 054 Nasal prosthesis - simple
9138 054 Nasal prosthesis - complex
9139 054 Ocular prosthesis - interim
9140 054 Ocular prosthesis - modified stock appliance
9141 054 Ocular prosthesis - custom appliance
9142 054 Orbital prosthesis - simple
9143 054 Orbital prosthesis - complex
9148 054 Unspecified body prosthesis - simple
9149 054 Unspecified body prosthesis - complex
9150 054 Facial prosthesis, surgical - simple
9151 054 Facial prosthesis, surgical - complex
9155 054 Cranial prosthesis
9156 054 Cranial implant prosthesis, custom made
9157 054 Facial implant prosthesis, custom made - simple
9158 054 Facial implant prosthesis, custom made – complex
9159 054 Ocular implant prosthesis, custom made
9160 054 Body implant prosthesis - custom made
9161 054 Surgical splint - simple
9162 054 Surgical splint - complex
9163 054 Surgical template - simple
9164 054 Surgical template - complex
9165 054 Surgical conformer - simple
9166 054 Surgical conformer - complex
9167 054 Trismus appliance (simple)
9168 054 Trismus appliance (complex)
9169 054 Orthoses appliance
9170 054 Facial palsy appliance
9171 054 Commissure splint
9172 054 Oral retractor, dynamic - per arm
9174 054 Unspecified burn appliance
9175 054 Theatre attendance (maxfac prosthod) /hour
9180 054 Surgical placement of sub-periosteal implant – preparatory stage
9181 054 Surgical placement of sub-periosteal implant – placement stage
9182 054 Surgical placement of endosteal implant plate
9183 054 Surgical placement of endosseus implant – first per quadrant
9184 054 Surgical placement of endosseus implant – second per quadrant
9185 054 Surgical placement of endosseus implant – third and subsequent per quadrant
9187 054 Cost of endosteal implant body
9188 054 Cost of prefabricated abutment
9189 054 Cost of other implant compnts
9190 054 Surgical exposure of endosseus implant – first per quadrant
9191 054 Surgical exposure of endosseus implant – second per quadrant
9192 054 Surgical exposure of endosseus implant – third and subsequent per quadrant
9198 054 Surgical removal of implant
9201 054 Consultation - oral pathologist
9203 054 House/hosp/nursing home consultation – oral pathologist
9205 054 Consultation - oral pathologist (subsequent)
9207 054 After hours visit - oral pathologist
9220 054 Repair cleft hard palate - unilateral
9222 054 Repair cleft hard palate - bilateral (one procedure)
9224 054 Repair cleft hard palate - bilateral (two procedures)
9226 054 Repair cleft soft palate - w/o muscle reconstruction
9228 054 Repair cleft soft palate - w/ muscle reconstruction
9230 054 Repair submucosal cleft and/or bifid uvula – w/ muscle reconstruction
9232 054 Uncomplicated
9234 054 Velopharyngeal reconstruction - complicated
9238 054 Repair oronasal fistula (one procedure)
9240 054 Repair oronasal fistula (two procedures)
9246 054 Secondary periosteal flaps
9248 054 Lipadhesion
9250 054 Repair cleft lip - unilateral w/o musclereconstruction
9252 054 Repair cleft lip - unilateral w/ muscle reconstruction
9254 054 Repair cleft lip - bilateral w/o muscle reconstruction
9256 054 Repair cleft lip - bilateral w/ muscle reconstruction
9258 054 Repair anterior nasal floor
9260 054 Revision of secondary cleft lip deformity – partial
9262 054 Revision of secondary cleft lip deformity – total w/ muscle reconstruction
9264 054 Abbe-flap - two stages
9266 054 Reconstruct columella
9268 054 Reconstruct nose due to cleft deformity – partial
9270 054 Reconstruct nose due to cleft deformity – complete
9272 054 Paranasal augmentation for nasal base deviation
9274 054 Repair anterior table, frontal sinus and/or supraorbital rim
9276 054 Repair anterior and posterior wall w/ obturation and/or cranialisation of frontal sinus
9278 054 Repair medial canthal ligament (canthopexy), per side
9280 054 Open reduction and fixation of nasal fractures
9282 054 Manipulation and immobilisation of nasal fracture
9284 054 Musculofascial flap
9286 054 Musculocranial flap
9288 054 Buccal fat pad (major repair)
9290 054 Maxillectomy - alveolus only, level i
9292 054 Maxillectomy - alveolus and sinus or nasal floor, level ii
9294 054 Maxillectomy - alveolus, sinus, nasal floor and zygoma excluding orbital rim level iii
9296 054 Maxillectomy - alveolus, sinus, nasal floor and zygoma including orbital rim level iv
9298 054 Maxillectomy - alveolus, sinus, nasal floor, zygoma, orbital rim and pterygoid plates level
9300 054 Hemiresection of jaw including condyle and coronoid process
9301 054 Casting and trimming of model in plaster (yellow/white), per model
9303 054 Casting and trimming of model in super-hard stone (die-stone) per model
9305 054 Casting and trimming of study model, per
9307 054 Casting and trimming of gnathostatic model, per model.
9309 054 New trimmed base to supplied model, per model
9311 054 Trimming of supplied model, per model
9312 054 Gingival tissue mask per implant
9313 054 Duplicating model, per model
9314 054 Refractory model, per unit
9315 054 Models and duplicate models (virgin model) for crown and bridge, work inclusive of one removable die
9317 054 Sectional models for crown and bridge, work inclusive of one removable die
9319 054 Each additional removable die for items 9315 and 9317 per die
9320 054 Indexed or model tray per die (not more than 9319)
9321 054 Occlusion block, per block
9323 054 Occlusion block on baseplate, per block
9327 054 Infection control per impression, denture (wax or acrylic) or any item in contact with body fluids
9329 054 Fit and supply of disposable articulator
9330 054 Delivery / collection fee per completed procedure (maximum 4)
9331 054 Full upper and lower dentures
9333 054 Full upper or lower denture
9335 054 Set-up and waxing of full upper and lower dentures
9337 054 Set-up and waxing of full upper or lower denture
9339 054 Waxing and finishing of full upper and lower dentures
9341 054 Waxing and finishing of full upper or lower denture
9343 054 Additional fee for dentures on fully adjustable articulator at request of dentist
9345 054 Additional fee for immediate dentures, or tooth socketed
9346 054 Additional fee for immediate dentures, per tooth not socketed.
9347 054 Additional fee for each retry from the third and upwards at an agreed quantum of time to be calculated at hourly rate
9351 054 Set-up and finish of one-tooth denture
9352 054 Set-up and finish of two-tooth denture
9353 054 Set-up and finish of three-tooth denture
9354 054 Set-up and finish of four-tooth denture
9355 054 Set-up and finish of five-tooth denture
9356 054 Set-up and finish of six-tooth denture
9357 054 Set-up and finish of seven-tooth denture
9358 054 Set-up and finish of eight-tooth denture
9359 054 Set-up and finish nine or more tooth denture
9361 054 Set-up and waxing of one-tooth denture
9362 054 Set-up and waxing of two-tooth denture
9363 054 Set-up and waxing of three-tooth denture
9364 054 Set-up and waxing of four-tooth denture
9365 054 Set-up and waxing of five-tooth denture
9366 054 Set-up and waxing of six-tooth denture
9367 054 Set-up and waxing of seven-tooth denture
9368 054 Set-up and waxing of eight-tooth denture
9369 054 Set-up and waxing of nine or more tooth denture
9371 054 Waxing and finishing of one-tooth denture
9372 054 Waxing and finishing of two-tooth denture
9373 054 Waxing and finishing of three-tooth denture
9374 054 Waxing and finishing of four-tooth denture
9375 054 Waxing and finishing of five-tooth denture
9376 054 Waxing and finishing of six-tooth denture
9377 054 Waxing and finishing of seven-tooth denture
9378 054 Waxing and finishing of eighth-tooth denture
9379 054 Waxing and finishing of nine or more tooth denture
9383 054 Additional fee for finishing denture in tooth colour material, per tooth
9385 054 Additional fee for supplying finished denture on duplicate model
9391 054 Basic charge which includes repair of one fracture, or addition of one tooth, or addition of one clasp
9393 054 Additional charge for each additional fracture, or tooth, or clasp
9395 054 Additional fee for using wire strengthener
9397 054 Additional fee for using pre-formed strengthener
9398 054 Additional fee for using mesh strengthener in repair procedure
9401 054 Clear base
9403 054 Dox grinding of upper and lower dentures
9405 054 Inlay to artificial tooth, one surface only, per inlay
9406 054 Inlay to artificial tooth, multi-surfaces e.g. Horseshoe or l-type inlay, per inlay
9407 054 Heka base technique per upper or lower
9409 054 Frego frame
9410 054 Bleaching tray
9411 054 Template per upper or lower denture
9413 054 Reline/rebase of single denture
9415 054 Remodel of single denture
9417 054 Soft base reline per denture
9419 054 Soft base to new denture, per denture
9421 054 Gum tinting per denture
9423 054 Lingual or palatal bar
9425 054 Cleaning and polishing of existing denture, per denture
9427 054 Mesh strengthener
9429 054 Theatre/ consultation out of laboratory per hour or part thereof
9431 054 Special tray, acrylic, each
9432 054 Special tray light cure, each
9433 054 Special tray in base plate material, each
9435 054 Provision of single arm clasp, to partial denture
9437 054 Provision of double arm clasp, to partial denture
9439 054 Provision of single arm clasp with rest, to partial denture
9441 054 Provision of double arm clasp with rest, to partial denture
9443 054 Provision of preformed roach clasp, to partial denture
9445 054 Provision of rest only to partial denture
9447 054 Cast clasp
9448 054 Casting and trimming of model from impression inside occlusion block or wax try in
9450 054 Finishing of acrylic work on any chrome cobalt or gold prosthesis
9451 054 Metal base for full upper or full lower denture each
9453 054 Basic charge - which excludes models and any special trays which may be required by the dentist, but includes refractory model
9455 054 Additional charge for each one arm clasp
9457 054 Additional charge for each roach clasp
9459 054 Additional charge for each rest
9461 054 Additional charge for continuous clasp, per tooth
9463 054 Additional charge for lingual bar, per tooth passed
9465 054 Additional charge for palatal bar
9467 054 Additional charge for onlay
9469 054 Additional charge for saddle with finishing line, per tooth
9471 054 Additional charge for saddle without finishing line, per tooth
9473 054 Additional charge for horseshoe saddle, per tooth
9475 054 Additional charge for fitting of tooth to metal backing, per tooth
9479 054 Additional charge for fitting one distal- extension hinge
9480 054 Additional charge per milled edge per tooth
9481 054 Additional charge for each soldering joint
9483 054 Additional charge for soldering retention
9485 054 Additional charge for each additional retention soldering joint
9487 054 Additional charge for each welding joint
9489 054 Additional charge for fitting swing lock
9491 054 Additional charge for each backing cast
9493 054 Additional charge for each steels backing or pontic cast (plastic work to be charged in addition)
9495 054 Basic fee for the repairing of or addition to any appliance necessitating the casting of a model (9301)
9497 054 Basic fee if a new section is to be fabricated and where item 9495 does not apply (9301)
9501 054 Ceramic jacket crown/ceromer crown or pontic
9502 054 Ceramic metal substitute coping
9505 054 Ceramic bonded crown or pontic
9507 054 Post-solder invested joint, per joint
9511 054 Inlay in porcelain veneer crown
9512 054 Ceramic, inlay/onlay, bridge retainer
9513 054 Ceramic post
9515 054 Porcelain shoulder per unit (not applicable to pontics)
9520 054 Additional fee for crown- & bridge work performed on a movable condyle articulator per unit
9521 054 Full metal crown, mod, three-quarter crown
9524 054 Indirect composite resin inlay
9525 054 Class iv, mo, do, cervical/occlusal inlay
9526 054 Additional fee for one piece casting of crown or inlay on post
9531 054 Pin-ledge inlay
9533 054 Full metal pontic
9535 054 Abutment thimble cast
9537 054 Precision lock and rest cast
9538 054 Lock and rest cast
9539 054 Casting of rest only
9541 054 Metal inlay or post, cast direct
9543 054 Gold/pre-solder invested joint
9545 054 Cast post with thimble, indirect
9546 054 Multiple post
9547 054 Manufacture cast post and core to existing crown
9549 054 C.s.p. Attachment (steiger)
9550 054 Milling milled edge per unit
9551 054 Telescope crown
9553 054 Composite/acrylic veneer crown/pontic, indirect
9557 054 Composite/acrylic jacket crown, indirect
9559 054 Composite/acrylic veneer post crown
9560 054 Indirect composite resin veneer
9561 054 Composite/acrylic jacket crown, direct
9563 054 Temporary acrylic/composite crown per unit
9564 054 Heat formed template supplied to dentist for the manufacture of temporary restorations
9565 054 Composite/acrylic-facing replaced
9566 054 Porcelain/ ceromer facing replaced
9569 054 Waxing of crown to existing denture
9570 054 Additional fee for each remake at an agreed quantum of time to be calculated at an hourly rate
9571 054 Basic charge which includes acrylic base
9572 054 Basic charge non acrylic base
9573 054 Additional charge for fitting first expansion screw
9575 054 Additional fee for fitting subsequent expansion screws
9576 054 Additional fee for full aclusal bite plate
9577 054 Additional fee for bite plate anterior
9578 054 Additional fee for bite plate posterior
9579 054 Additional fee for fitting tongue guard
9581 054 Additional fee for flat or inclined plane
9583 054 Additional fee for adams crib
9585 054 Additional fee for jackson crib
9587 054 Additional fee for ball clasp
9589 054 Additional fee for single arm clasp
9591 054 Additional fee for double arm clasp
9593 054 Additional fee for fitting single loop finger spring
9595 054 Additional fee for fitting double loop finger spring
9597 054 Additional fee for fitting buccal retraction spring
9599 054 Additional fee for fitting apron spring
9603 054 Additional fee for fitting coffin spring
9605 054 Additional fee for fitting quad helix
9607 054 Ddition l fee for fitting fl pper or “t”-spring
9609 054 Additional fee for fitting all springs with tubing, each
9611 054 Additional fee for fitting labial arch
9613 054 Additional fee for fitting buccal arch
9615 054 Additional fee for fitting roberts retractor
9617 054 Invisible retainer
9619 054 Additional fee for fitting twin wire arch extra- oral arch
9620 054 Additional fee lip bumper
9621 054 Additional fee for fitting extra-oral arch
9622 054 Additional fee for fitting space maintainer
9623 054 Additional fee for each spot-welding joint
9625 054 Additional fee for each soldering joint
9627 054 Additional fee for each invested soldering joint
9629 054 Additional fee for each hook for elastic traction
9631 054 Mouth protector (gum guard)
9633 054 Oral screen
9635 054 Andresen or norwegian appliance
9637 054 Tooth positioner
9639 054 Gunning splint
9641 054 Frankel appliance
9643 054 Chin cap
9645 054 Bionator
9646 054 Diagnostic set-up
9647 054 Snoring appliance
9651 054 Pinched or swaged band with welded attachment (excluding cost of attachment)
9653 054 Pinched or swaged band with soldered attachment
9662 054 Additional fee for each remake at an agreed quantum of time to be calculated at an hourly rate
9700 054 Diatorics 1 x 6/8
9702 054 Diatorics, odds, anterior
9704 054 Diatorics, odds, posterior
9706 054 Cost of bleaching tray material
9720 054 Soft base material per denture
9722 054 Acrylic per denture
9724 054 Cost of precision attachment, per attachment
9726 054 Preformed ball or roach clasp
9728 054 Cost of lingual / palatal bar
9729 054 Cost of mesh strengthener
9730 054 Cost of pre-fabricated burn-out component, per component
9732 054 Cost of other attachment components e.g. Nylon caps, sleeves etc
9734 054 Cost of dolder bar and clips, per gram or per clip
9736 054 Cost of implant components
9738 054 Cost of preformed strengthener
9739 054 Additional charge gold plating
9740 054 Cost of gold wire, per gram
9741 054 Cost of cobalt chrome casting alloy
9742 054 Cost of specialised cobalt chrome casting metal e g vitallium, titanium
9744 054 Cost of precious casting alloy
9746 054 Cost of semi-precious casting alloy
9748 054 Cost of non-precious casting alloy
9752 054 Cost of platinum foil
9754 054 Cost of gold solder, per gram
9755 054 Etching for bonding (metal or ceramic)
9756 054 Cost of silver solder, per gram
9757 054 Ceromer material - per unit
9758 054 Fiber re-enforced material per unit
9759 054 Fibre post
9760 054 Composite restoration material
9761 054 Ceramic material
9762 054 Cost of anterior orthodontic attachment, per attachment
9763 054 Orthodontic material
9764 054 Cost of posterior orthodontic attachment, per attachment
9765 054 Preformed components
9766 054 Cost of expansion screw, per screw
9767 054 Soldering material
9768 054 Cost of buccal tube/transfer tube, per tube
9770 054 Cost of j-hook, per hook
9772 054 Cost of lingual buttons, per button
9774 054 Cost of invisible retainer material
9775 054 R/a case
9776 054 Cost of mouth protector material
9778 054 Cost of arch wire
9779 054 Dual laminate material
9780 054 Positioning and finishing of complete (male and female) prefabricated burn-out attachment
9782 054 Positioning and soldering of complete (male and female) precision attachment
9783 054 Implant stent per unit
9784 054 Alignment of dolder bar and clips
9786 054 Trimming, waxing and finishing of implant abutment - crown and bridge work only, per abutment
9787 054 Waxing, milling and finishing of a custom abutment
9788 054 Implant superstructure (edentulous cases) including placing of preformed parts, per section cast
9789 054 Finishing of prosthesis on implant structure per arch
8025 062 Handling fee - direct materials
8101 062 Oral examination
8102 062 Comprehensive oral examination
8104 062 Limited oral examination
8106 062 Special report
8107 062 Intraoral radiograph - periapical
8108 062 Intraoral radiographs - complete series
8109 062 Infection control/barrier techniques
8110 062 Sterilized instrumentation
8112 062 Intraoral radiograph - bitewing
8113 062 Intraoral radiograph - occlusal
8114 062 Extraoral radiograph - hand-wrist
8115 062 Extraoral radiograph - panoramic
8116 062 Extraoral radiograph - cephalometric
8117 062 Diagnostic models
8118 062 Extraoral radiograph - skull/facial bone
8119 062 Diagnostic models mounted
8120 062 Treatment plan completed
8121 062 Oral and/or facial image
8123 062 Caries susceptibility tests (by arrangement)
8124 062 Pulp tests
8129 062 Office/hospital visit - after regularly scheduled hours
8131 062 Emergency dental treatment
8132 062 Pulp removal (pulpectomy)
8133 062 Recement inlay, onlay, crown or veneer
8135 062 Remove inlay, onlay or crown
8136 062 Access through a prosthetic crown or inlay to facilitate root canal treatment
8137 062 Emergency crown (chair-side)
8138 062 Remove retention post (prefabricated or cast)
8139 062 Appointment not kept /30min
8140 062 House/extended care facility/hospital call
8141 062 Inhalation sedation - first 15 minutes or part thereof
8143 062 Inhalation sedation - each addnl 15 minutes
8144 062 Intravenous sedation
8145 062 Local anaesthetic - per visit
8146 062 Resin bonding for restorations
8147 062 Monitoring equipment for intravenous sedation
8151 062 Oral hygiene instruction
8153 062 Oral hygiene instruction - each additional visit
8154 062 Oral examination - oral hygienist
8155 062 Polishing - complete dentition
8157 062 Re-burnishing and polishing of restorations – complete dentition
8158 062 Enamel microabrasion
8159 062 Prophylaxis - complete dentition
8160 062 Removal of gross calculus
8161 062 Topical application of fluoride - child
8162 062 Topical application of fluoride - adult
8163 062 Dental sealant
8164 062 Limited oral examination - oral hygienist
8165 062 Sedative filling
8166 062 Application of desensitising resin, per tooth
8167 062 Application of desensitising medicament, per visit
8169 062 Occlusal guard
8171 062 Mouth protector
8172 062 Cost of orthotic appliance
8173 062 Space maintainer - fixed, per abutment
8175 062 Space maintainer - removable
8176 062 Periodontal screening
8177 062 Oral hygiene instruction (periodontally compromised patient)
8178 062 Oral hygiene instruction - each additional visit (periodontally compromised patient)
8179 062 Polishing - complete dentition (periodontally compromised patient)
8180 062 Prophylaxis - complete dentition (periodontally compromised patient)
8183 062 Therapeutic drug injection
8189 062 Re-examination - existing condition
8190 062 Consultation - second opinion or advice
8192 062 Suture - minor
8194 062 Cbct capture and interpretation with limited field of view - less than one whole jaw
8195 062 Cbct capture and interpretation with limited field of view of one full arch - mandible
8196 062 Cbct capture and interpretation with limited field of view of one full arch - maxilla without orbits and/or cranium
8197 062 Cbct capture and interpretation with limited field of view of both dental arches – without orbits and/or cranium
8198 062 Cbct capture and interpretation for tmj series including two or more exposures
8199 062 Cbct capture and interpretation with limited field of view of one full arch - maxilla with orbits and/or cranium
8200 062 Cbct capture and interpretation with field of view of both dental arches - with orbits and/or cranium
8201 062 Extraction - tooth or exposed tooth roots (first per quadrant)
8202 062 Extraction - each additional tooth or exposed tooth roots
8213 062 Surgical removal of residual roots, first tooth per quadrant
8214 062 Surgical removal of residual roots, second and subsequent teeth''s roots
8220 062 Cost of suture material
8228 062 Art restorations
8231 062 Complete dentures - maxillary and mandibular
8232 062 Complete denture - maxillary or mandibular
8233 062 Partial denture - resin base - one tooth
8234 062 Partial denture - resin base - two teeth
8235 062 Partial denture - resin base - three teeth
8236 062 Partial denture - resin base - four teeth
8237 062 Partial denture - resin base - five teeth
8238 062 Partial denture - resin base - six teeth
8239 062 Partial denture - resin base - seven teeth
8240 062 Partial denture - resin base - eight teeth
8241 062 Partial denture - resin base - nine or more teeth
8244 062 Immediate denture - maxillary
8245 062 Immediate denture - mandibular
8251 062 Clasp or rest - cast gold
8253 062 Clasp or rest - wrought gold
8255 062 Clasp or rest - stainless steel
8257 062 Bar - lingual or palatal
8259 062 Rebase complete or partial denture
8261 062 Remodel complete or partial denture
8263 062 Reline complete or partial denture (chair-side)
8265 062 Tissues conditioning per arch (including soft self-cure reline)
8267 062 Reline complete or partial denture
8269 062 Repair denture or other intra-oral appliance
8270 062 Add clasp to existing partial denture
8271 062 Add tooth to existing partial denture
8273 062 Impression to repair or modify a denture or other intra-oral appliance
8275 062 Adjust complete or partial denture
8277 062 Inlay in denture
8281 062 Partial denture - cast metal framework only
8301 062 Pulp cap - direct
8303 062 Pulp cap - indirect
8304 062 Rubber dam per arch
8306 062 Cost of mta
8307 062 Pulp amputation (pulpotomy)
8310 062 Supply of bleaching materials
8325 062 Internal bleaching - per tooth
8327 062 Internal bleaching - each additional visit
8328 062 Root canal obturation - anteriors and premolars - each additional canal
8329 062 Root canal therapy - anteriors and premolars – each additional canal
8330 062 Removal of root canal obstruction
8332 062 Root canal preparatory visit - single canal tooth
8333 062 Root canal preparatory visit - multi canal
8334 062 Re-treatment of previously completed root canal therapy, per canal
8335 062 Root canal obturation - anteriors and premolars - first canal
8336 062 Root canal obturation - posteriors - first canal
8337 062 Root canal obturation - posteriors – each additional canal
8338 062 Root canal therapy - anteriors and premolars – first canal
8339 062 Root canal therapy - posteriors - first canal
8340 062 Root canal therapy - posteriors – each additional canal
8341 062 Amalgam - one surface
8342 062 Amalgam - two surfaces
8343 062 Amalgam - three surfaces
8344 062 Amalgam - four or more surfaces
8345 062 Prefabricated post retention, per post (in addition to restoration)
8347 062 Pin retention - first pin (in addition to restoration)
8348 062 Pin retention - each additional pin (in addition to restoration)
8349 062 Carve restoration to accommodate existing removable prosthesis
8350 062 Resin crown - anterior primary tooth (direct)
8351 062 Resin - one surface, anterior
8352 062 Resin - two surfaces, anterior
8353 062 Resin - three surfaces, anterior
8354 062 Resin - four or more surfaces, anterior
8355 062 Veneer - resin (chair-side)
8357 062 Prefabricated metal crown
8361 062 Inlay - metal - one surface
8362 062 Inlay/onlay - metal - two surfaces
8363 062 Inlay/onlay - metal - three surfaces
8364 062 Inlay/onlay - metal - four or more surfaces
8366 062 Pin retention as part of cast restoration (any number of pins)
8367 062 Resin - one surface, posterior
8368 062 Resin - two surfaces, posterior
8369 062 Resin - three surfaces, posterior
8370 062 Resin - four or more surfaces, posterior
8371 062 Inlay - porcelain - one surface
8372 062 Inlay/onlay - porcelain - two surfaces
8373 062 Inlay/onlay - porcelain - three surfaces
8374 062 Inlay/onlay - porcelain - four or more surfaces
8375 062 Prefabricated resin crown
8376 062 Core build-up with prefabricated posts
8379 062 Cost of prefabricated posts
8381 062 Inlay - resin - one surface
8382 062 Inlay/onlay - resin - two surfaces
8383 062 Inlay/onlay - resin - three surfaces