Dental ADA Codes
Translation of Current Dental Terminology © American Dental Association ® (updated January 2024)
ADA Code |
Description |
Amount |
|
Examinations
|
|
D010 0 |
Missed Appointment (without proper cancellation) |
45.00 |
D012 0 |
Periodic Oral Evaluation (Patient is seen within one year) |
60.00 |
D0140 |
Limited Oral Evaluation – Problem Focused |
85.00 |
D015 0 |
Comprehensive Oral Evaluation – New or Established Patient |
90.00 |
D016 0 |
Detailed & Extensive Oral Evaluation – Problem Focused (Emergency Exam) |
150.00 |
D017 0 |
Re-evaluation – Limited, Problem Focused |
85.00 |
D018 0 |
Comprehensive Periodontal Evaluation – New or Established Patient |
115.00 |
|
Radiography
|
|
D021 0 |
Intraoral – Complete Series (including bitewings) |
120.00 |
D022 0 |
Intraoral – Periapical First Film |
35.00 |
D0230 |
Intraoral – Periapical Each Additional Film |
20.00 |
D024 0 |
Intraoral – Occlusal Film |
55.00 |
D025 0 |
Extraoral – First Film |
55.00 |
D0260 |
Extraoral – Each Additional Film |
55.00 |
D027 0 |
Bitewing – Single Film |
25.00 |
D027 2 |
Bitewing – Two Films |
40.00 |
D0274 |
Bitewing – Four Films |
57.00 |
D027 7 |
Vertical Bitewings – 7 or 8 Films |
90.00 |
D028 0 |
Copy of X-Rays |
50.00 |
D033 0 |
Panoramic Film |
115.00 |
|
|
|
D033 3 |
Custom Tray |
40.00 |
|
|
|
D111 0 |
Prophylaxis – Adult |
105.00 |
D133 0 |
Oral Hygiene Instructions |
40.00 |
|
Restorations
|
|
D214 0 |
Amalgam – One Surface, Primary or Permanent |
130.00 |
D215 0 |
Amalgam – Two Surfaces, Primary or Permanent |
145.00 |
D2160 |
Amalgam – Three Surfaces, Primary or Permanent |
160.00 |
D216 1 |
Amalgam – Four or More Surfaces, Primary or Permanent |
180.00 |
D233 0 |
Resin-Based Composite – One Surface, Anterior |
170.00 |
D2331 |
Resin-Based Composite – Two Surfaces, Anterior |
235.00 |
D233 2 |
Resin-Based Composite – Three Surfaces, Anterior |
285.00 |
D233 5 |
Resin-Based Composite – Four or More Surfaces, Anterior or Involving Incisal Area |
295.00 |
D239 1 |
Resin-Based Composite – One Surface, Posterior |
200.00 |
D239 2 |
Resin-Based Composite – Two Surfaces, Posterior |
265.00 |
D2393 |
Resin-Based Composite – Three Surfaces, Posterior |
295.00 |
D239 4 |
Resin-Based Composite – Four or More Surfaces, Posterior |
310.00 |
|
|
|
D270 0 |
Crown Delivery |
0.00 |
D271 0 |
Crown – Resin (indirect) |
550.00 |
D2740 |
Crown – Porcelain/Ceramic |
1250.00 |
D275 1 |
Crown – Porcelain Fused to Predominantly Base Metal |
900.00 |
D279 9 |
Provisional Crown (for Crown Prep) |
0.00 |
D2920 |
Recement Crown |
95.00 |
D294 0 |
Sedative Filling (Temp Filling IRM/Cavity) |
85.00 |
D295 0 |
Core Buildup, including any pins |
240.00 |
D2954 |
Prefabricated Post & Core in Addition to Crown |
240.00 |
D297 0 |
Temporary Crown (for Fractured Tooth or Long-Term Use) |
350.00 |
|
|
|
D311 0 |
Pulp Cap – Direct (Excluding Final Restoration) |
60.00 |
D312 0 |
Pulp Cap – Indirect (Excluding Final Restoration) |
55.00 |
D3220 |
Therapeutic Pulpotomy (Excluding Final Restoration) |
250.00 |
D322 1 |
Pulpal Debridement, Primary & Permanent Teeth |
200.00 |
D330 1 |
Root Canal Finish |
0.00 |
D3310 |
Anterior Root Canal Therapy (Excluding Final Restoration) |
650.00 |
D332 0 |
Bicuspid Root Canal Therapy (Excluding Final Restoration) |
750.00 |
D333 0 |
Molar Root Canal Therapy (Excluding Final Restoration) |
850.00 |
D3346 |
Retreatment of Previous Root Canal Therapy - Anterior |
800.00 |
D334 7 |
Retreatment of Previous Root Canal Therapy – Bicuspid |
850.00 |
D334 8 |
Retreatment of Previous Root Canal Therapy – Molar |
900.00 |
|
|
|
D4210 |
Gingivectomy or Gingivoplasty –Per Quadrant |
600.00 |
D4211 |
Gingivectomy or Gingivoplasty – 1-3 Teeth |
250.00 |
D4249 |
Clinical Crown Lengthening – Hard Tissue |
750.00 |
D4341 |
Periodontal Scaling & Root Planing –Per Quad |
198.00 |
D4342 |
Periodontal Scaling & Root Planing– 1-3 Teeth |
75.00 |
D4355 |
Full Mouth Debridement to Enable Comprehensive Periodental Eval |
200.00 |
D4910 |
Periodontal Maintenance |
85.00 |
|
Prosthodontics
|
|
D5100 |
Denture/Partial/Interim Delivery |
0.00 |
D5106 |
Denture Adjustment |
75.00 |
D5110 |
Complete Denture – Maxillary |
1450.00 |
D5120 |
Complete Denture – Mandibular |
1450.00 |
D5130 |
Immediate Denture – Maxillary |
1750.00 |
D5140 |
Immediate Denture – Mandibular |
1750.00 |
D5211 |
Maxillary Partial Denture – Resin Base |
1450.00 |
D5212 |
Mandibular Partial Denture – Resin Base |
1450.00 |
D5281 |
Removable Unilateral Partial Denture – One Piece Cast Metal |
1400.00 |
D5410 |
Adjust Complete Denture – Maxillary |
85.00 |
D5411 |
Adjust Complete Denture – Mandibular |
85.00 |
D5421 |
Adjust Partial Denture – Maxillary |
85.00 |
D5422 |
Adjust Partial Denture – Mandibular |
85.00 |
D5510 |
Repair Broken Complete Denture Base |
450.00 |
D5520 |
Replace Missing or Broken Teeth – Complete Denture (Each Tooth) |
150.00 |
D5610 |
Repair Resin Denture Base |
200.00 |
D5620 |
Repair Cast Framework |
250.00 |
D5630 |
Repair or Replace Broken Clasp |
250.00 |
D5640 |
Repair Broken Teeth – Per Tooth |
175.00 |
D5650 |
Add Tooth to Existing Partial Denture |
175.00 |
D5660 |
Add Clasp to Existing Partial Denture |
275.00 |
D5670 |
Replace All Teeth & Acrylic on Cast Metal Framework (Maxillary) |
850.00 |
D5671 |
Replace All Teeth & Acrylic on Cast Metal Framework (Mandibular) |
850.00 |
D5730 |
Reline Complete Maxillary Denture (Chairside) |
350.00 |
D5731 |
Reline Complete Mandibular Denture (Chairside) |
350.00 |
D5740 |
Reline Maxillary Partial Denture (Chairside) |
350.00 |
D5741 |
Reline Mandibular Partial Denture (Chairside) |
350.00 |
D5750 |
Reline Complete Maxillary Denture (Laboratory) |
400.00 |
D5751 |
Reline Complete Mandibular Denture (Laboratory) |
400.00 |
D5760 |
Reline Maxillary Partial Denture (Laboratory) |
400.00 |
D5761 |
Reline Mandibular Partial Denture (Laboratory) |
400.00 |
D5820 |
Interim Partial Denture Maxillary (Flipper) |
750.00 |
D5821 |
Interim Partial Denture Mandibular - (Flipper) |
750.00 |
|
Bridges
|
|
D6200 |
Bridge Delivery |
0.00 |
D6242 |
Pontic – Porcelain Fused to Noble Metal |
950.00 |
D6752 |
Crown – Porcelain Fused to Noble Metal |
960.00 |
|
Extractions |
|
D7130 |
Root Removal of Exposed Roots |
175.00 |
D7140 |
Extraction, Erupted Tooth or Exposed Root (elevation &/or forceps) |
150.00 |
D7210 |
Surgical Removal of Erupted Tooth Requiring Elevation |
450.00 |
D7220 |
Removal of Impacted Tooth – Soft Tissue |
300.00 |
D7230 |
Removal of Impacted Tooth – Partially Bony |
450.00 |
D7240 |
Removal of Impacted Tooth – Completely Bony |
500.00 |
D7250 |
Surgical Removal of Residual Tooth Roots (Cutting Procedure) |
300.00 |
|
Miscellaneous
|
|
D9970 |
Enamel Microabrasion (Smoothing/Filing of a Tooth) |
90.00 |
D9910 |
Application of Desensitizing Meds |
85.00 |
|
Pharmaceuticals |
|
D9001 |
Penicillin (1 tab) |
0.50 |
D9002 |
Amoxicillin 4 tabs (premed) |
1.20 |
D9003 |
Amoxicillin 4 tabs (premed) |
0.30 |
D9004 |
Ibuprofen (1 tab) |
0.60 |
D9005 |
Cephalexin (1 tab) |
1.33 |
D9006 |
Clindamycin 2 x 150mg |
5.87 |
D9007 |
Clindamycin 2 x 300mg |
10.45 |
D9008 |
Clindamycin HCl 2 x 150mg |
1.67 |
D9009 |
Clindamycin HCl 2 x 300mg |
5.31 |
D9010 |
Clindamycin Azasan 2 x 75mg |
4.40 |
|
|
|
|
Fees with No Buttons Created (You must manually input these in the patient's ledger)
|
|
D0100 |
Missed Appointment (without proper cancellation) |
45.00 |
D0280 |
Copy of X-Rays |
50.00 |
D2710 |
Crown – Resin (indirect) |
550.00 |
D3346 |
Retreatment of Previous Rooth Canal Therapy - Anterior |
800.00 |
D3347 |
Retreatment of Previous Rooth Canal Therapy – Bicuspid |
850.00 |
D3348 |
Retreatment of Previous Rooth Canal Therapy – Molar |
900.00 |
D4249 |
Clinical Crown Lengthening – Hard Tissue |
750.00 |
D5750 |
Reline Complete Maxillary Denture (Laboratory) |
400.00 |
D5751 |
Reline Complete Mandibular Denture (Laboratory) |
400.00 |
D5760 |
Reline Maxillary Partial Denture (Laboratory) |
400.00 |
D5761 |
Reline Mandibular Partial Denture (Laboratory) |
400.00 |
D6242 |
Pontic – Porcelain Fused to Noble Metal |
950.00 |
D6752 |
Crown – Porcelain Fused to Noble Metal |
960.00 |
D7130 |
Root Removal of Exposed Roots |
175.00 |
D7250 |
Surgical Removal of Residual Tooth Roots (Cutting Procedure) |
300.00 |
D9910 |
Application of Desensitizing Meds |
85.00 |
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