Complete oral examination procedures
Comprehensive oral evaluation - new or established patient
Cone beam CT capture and interpretation with field of view of both jaws, with or without cranium
Panoramic radiographic image
Bitewings - four radiographic images
Intraoral - periapical first radiographic image
Intraoral - periapical each additional radiographic image
Routine periodic examination procedures
Periodic oral evaluation - established patient
Bitewings - four radiographic images
Intraoral - periapical first radiographic image
Intraoral - periapical each additional radiographic image
Limited oral examination procedures
Brief assessment
Bitewing - single radiographic image
Intraoral - periapical first radiographic image
Intraoral - periapical each additional radiographic image
Common direct restorative procedures
Resin-based composite - one surface, anterior
Resin-based composite - two surfaces, anterior
Resin-based composite - three surfaces, anterior
Resin-based composite - four or more surfaces, anterior
Resin-based composite - one surface, posterior
Resin-based composite - two surfaces, posterior
Resin-based composite - three surfaces, posterior
Resin-based composite - four or more surfaces, posterior
Amalgam - one surface
Amalgam - two surfaces
Amalgam - three surfaces
Amalgam - four or more surfaces
Placement of interim direct restoration
Crown preparation and related procedures
Core buildup
Crown - porcelain/ceramic substrate
3D dental surface scan - direct
Removal of previous crown
Complete and partial dentures
Complete denture - maxillary
Complete denture - mandibular
Immediate denture - maxillary
Immediate denture - mandibular
Interim partial denture - maxillary
Interim partial denture - mandibular
Maxillary partial denture - resin base / valplast
Mandibular partial denture - resin base / valplast
Maxillary partial denture - cast metal framework with resin denture bases
Mandibular partial denture - cast metal framework with resin denture bases
Adjust complete denture - maxillary
Adjust complete denture - mandibular
Adjust partial denture - maxillary
Adjust partial denture - mandibular
Repair broken complete denture base
Repair broken partial denture base
Repair or replace broken clasp
Replace broken teeth - complete denture
Replace broken teeth - partial denture
Add tooth to existing partial denture
Add clasp to existing partial denture
Initial implant placement procedures
Surgical placement of implant body: endosteal implant
Radiographic/surgical implant index
Treatment simulation using 3D image volume or surface scan
Fusion of two or more 3D image volumes of one or more modalities
Second stage implant procedures
Second stage implant surgery
Implant crown delivery procedures
Custom abutment
Abutment-supported porcelain/ceramic crown
Abutment-supported metal crown
Endodontic treatment procedures
Cone beam CT capture and interpretation with limited field of view - less than one whole jaw
Pulpal debridement
Anterior tooth
Premolar tooth
Molar tooth
Treatment of root canal obstruction
Placement of interim direct restoration
Tooth extraction procedures
Simple extraction
Surgical extraction
Gelfoam or collagen plug (placement of intra-socket biological dressing to aid in hemostasis or clot stabilization)
Bone graft - per site
Bridge sectioning