Discovery Dental Tariff Codes 2021

 

DISCOVERY HEALTH
2021 DENTAL PRACTITIONER RATES
Procedure Code Procedure Description  Scheme Rate
8101 Oral examination 257.40
8102 Comprehensive oral examination 386.30
8103 Extensive oral examination – condition focused combined consultation for  complex treatment planning 0.00
8104 Limited oral examination 124.80
8105 Case presentation – extensive treatment planning 0.00
8106 Special report 245.50
8107 Intraoral radiograph – periapical 111.60
8108 Intraoral radiographs – complete series 749.50
8109 Infection control/barrier techniques 24.80
8110 Sterilized instrumentation 55.50
8111 Dental testimony 0.00
8112 Intraoral radiograph – bitewing 111.60
8113 Intraoral radiograph – occlusal 166.80
8114 Extraoral radiograph – hand-wrist 387.20
8115 Extraoral radiograph – panoramic 387.20
8116 Extraoral radiograph – cephalometric 387.20
8117 Diagnostic models 103.80
8118 Extraoral radiograph – skull/facial bone 387.20
8119 Diagnostic models mounted 261.50
8120 Treatment plan completed 0.00
8121 Oral and/or facial image (digital/conventional) 103.80
8122 Microbiological studies 0.00
8123 Caries susceptibility tests (By Arrangement) 0.00
8124 Pulp tests 28.60
8125 Pulp tests –more than 3 teeth 0.00
8126 Digital Diagnostic Models 103.80
8129 Office/hospital visit  after regularly scheduled hours 360.20
8130 Rebond veneer 0.00
8131 Emergency dental treatment 146.80
8132 Pulp removal (pulpectomy) 276.60
8133 Recement inlay, onlay, crown or veneer 146.80
8134 Recement cast core or post 146.80
8135 Remove inlay, onlay or crown 292.40
8136 Access through a prosthetic crown or inlay to facilitate root canal treatment 131.00
8137 Emergency crown (chair-side) 503.80
8138 Remove retention post (prefabricated or cast) 191.80
8139 Appointment not kept /30min 0.00
8140 House/extended care facility/hospital call 238.50
8141 Inhalation sedation – first 15 minutes or part thereof 107.50
8142 Recement inlay/onlay/veneer 146.80
8143 Inhalation sedation – each addnl 15 minutes 55.80
8144 Intravenous sedation 64.50
8145 Local anaesthetic – per visit 100.60
8146 Resin bonding for restorations 0.00
8147 Monitoring equipment for intravenous sedation 229.40
8148 Use of dental operating microscope 0.00
8149 Nutritional counselling 0.00
8150 Tobacco counselling 0.00
8151 Oral hygiene instruction 146.80
8153 Oral hygiene instruction – each additional visit 107.50
8155 Polishing – complete dentition 146.80
8156 Removal of inlay/onlay/Veneer 292.40
8157 Re-burnishing and polishing of restorations – complete dentition 146.80
8158 Enamel microabrasion 134.50
8159 Prophylaxis – complete dentition 288.70
8160 Removal of gross calculus 0.00
8161 Topical application of fluoride – child 146.80
8162 Topical application of fluoride – adult 146.80
8163 Dental sealant 97.00
8165 Sedative filling 146.80
8166 Application of desensitising resin, per tooth 97.00
8167 Application of desensitising medicament, per visit 113.00
8168 Behavior management 0.00
8169 Occlusal guard 564.30
8170 Cost of Mouth Protector 0.00
8171 Mouth guard 0.00
8172 Cost of orthotic appliance Blank
8173 Space maintainer – fixed, per abutment 272.70
8174 Recementation of space maintainer 146.80
8175 Space maintainer  – removable 351.50
8176 Periodontal screening 201.20
8177 Oral hygiene instruction (periodontally compromised patient) 222.00
8178 Oral hygiene instruction – each additional visit (periodontally compromised patient) 120.00
8179 Polishing – complete dentition (periodontally compromised patient) 168.30
8180 Prophylaxis – complete dentition (periodontally compromised patient) 313.60
8183 Therapeutic drug injection 64.50
8189 Re-examination – existing condition 115.70
8190 Consultation – second opinion or advice 239.30
8192 Suture – minor 724.40
8193 Three-dimensional reconstruction of cone beam volumetric image using existing data (includes multiple images) 0.00
8194 CBCT capture and interpretation with limited field of view – less than one whole jaw 961.40
8195 CBCT capture and interpretation with limited field of  view  of one full dental arch -mandible 1074.00
8196 CBCT capture and interpretation with limited field of  view  of one full dental arch – maxilla 1074.00
8197 CBCT capture and interpretation with limited field of  view  of both dental arches without orbits and/or cranium 1125.20
8198 CBCT capture and interpretation for TMJ series including two or more exposures. 1125.20
8199 CBCT capture and interpretation with limited field of view of one full dental arch – maxilla with orbits and/or cranium 0.00
8200 CBCT capture and interpretation with field of view of both dental arches – with orbits and/or cranium 0.00
8201 Extraction – tooth or exposed tooth roots (first per quadrant) 168.90
8202 Extraction – each additional tooth or exposed tooth roots 68.40
8203 Interpretation of diagnostic image by a practitioner not associated with capture of the image, including the report 409.10
8204 Minimally traumatic tooth/root removal  (aimed at direct / immediate implant placement) 0.00
8205 CBCT  image capture with limited field of  view – less than one whole jaw 577.00
8206 CBCT image capture with limited field of  view  of one full dental arch -mandible 644.60
8207 CBCT image capture with limited field of view of one full dental arch – maxilla without orbits and/or cranium 644.60
8208 CBCT capture with limited field of view of both dental arches – without orbits and/or cranium 675.10
8209 CBCT capture for TMJ series including two or more exposures. 675.10
8210 CBCT capture with limited field of view of one full dental arch – maxilla with orbits and/or cranium 0.00
8211 CBCT capture with field of view of both dental arches – with orbits and/or cranium 0.00
8212 Interpretation of diagnostic image by a practitioner associated with capture of the image, including the report 0.00
8213 Surgical removal of residual roots, first tooth – per tooth 635.00
8214 Surgical removal of residual roots, second and subsequent teeth’s roots 489.40
8215 Impressions for the purpose of establishing virtual models for use in planning software
(this code may be reported with the appropriate code for impression material 9753)
0.00
8216 CBCT of plaster models or impressions for the purpose of creating virtual models for use in   planning software 0.00
8217 CBCT capture and interpretation  for the visualisation of sinuses 0.00
8218 CBCT capture for the visualisation of sinuses 0.00
8219 Report by a third party on pathology, implant measurements, endodontics, orthodontic measurements, nerve proximities etc 0.00
8220 Cost of suture material Blank
8231 Complete dentures – maxillary and mandibular 2369.80
8232 Complete denture – maxillary or mandibular 1461.20
8233 Partial denture – resin base – one tooth 679.30
8234 Partial denture – resin base – two teeth 679.30
8235 Partial denture – resin base – three teeth 1016.50
8236 Partial denture – resin base – four teeth 1016.50
8237 Partial denture – resin base – five teeth 1016.50
8238 Partial denture – resin base – six teeth 1348.00
8239 Partial denture – resin base – seven teeth 1348.00
8240 Partial denture – resin base – eight teeth 1348.00
8241 Partial denture – resin base – nine or more teeth 1348.00
8244 Immediate denture – maxillary 1461.20
8245 Immediate denture – mandibular 1461.20
8246 Immediate denture – Partial (report in addition to partial denture codes) 0.00
8251 Clasp or rest – cast gold 134.50
8253 Clasp or rest – wrought gold 134.50
8255 Clasp or rest – stainless steel 141.50
8257 Bar – lingual or palatal 166.80
8259 Rebase complete or partial denture (laboratory) 554.10
8261 Remodel complete or partial denture 889.00
8263 Reline complete or partial denture (chair-side) 351.50
8265 Tissues conditioning per arch (including soft self-cure reline) 229.40
8267 Reline complete or partial denture (laboratory) 808.40
8269 Repair denture or other intra-oral appliance 214.70
8270 Add clasp to existing partial denture 134.50
8271 Add tooth to existing partial denture 134.50
8273 Impression to repair or modify a denture or other intra-oral appliance 107.50
8275 Adjust complete or partial denture 107.50
8277 Inlay in denture 0.00
8281 Partial denture – cast metal framework only 1584.90
8283 Partial denture – Flexidenture framework 0.00
8284 Full denture –Flexidenture framework 0.00
8301 Pulp cap – direct 195.30
8303 Pulp cap – indirect 195.30
8304 Rubber dam per arch 115.00
8306 Cost of MTA Blank
8307 Pulp amputation (pulpotomy) 191.80
8308 External bleaching – per arch 0.00
8309 Home bleaching – instructions and applicator 0.00
8310 Supply of bleaching materials 0.00
8311 Home bleaching – subsequent visit 0.00
8312 Root canal therapy – anterior primary tooth  Anterior primary teeth include incisors and canines. Prep and obturation 0.00
8313 Root canal therapy – posterior primary tooth 0.00
8317 Root canal preparation, each additional canal – molar Preparation of the canal. May require further appointments to prepare the canal. Obturation is done in a subsequent appointment. 0.00
8318 Irrigation and medication per tooth at a separate visit 146.80
8323 Retreatment of previously completed root canal therapy, each additional canal – anterior or premolar 0.00
8324 Retreatment of previously completed root canal therapy, each additional canal – molar 0.00
8325 Internal bleaching – per tooth 0.00
8327 Internal bleaching – each additional visit 0.00
8328 Root canal obturation – anteriors and premolars – each additional canal 272.70
8329 Root canal therapy – anteriors and premolars – each additional canal 340.20
8330 Removal of root canal obstruction 191.80
8331 Repair of perforation defects 0.00
8332 Root canal preparatory visit – single canal tooth 146.80
8333 Root canal preparatory visit – multi canal tooth 206.50
8334 Re-preparation of previously obturated root canal 217.10
8335 Root canal obturation – anteriors and premolars – first canal 666.80
8336 Root canal obturation – posteriors – first canal 917.90
8337 Root canal obturation – posteriors – each additional canal 272.70
8338 Root canal therapy – anteriors and premolars – first canal 1020.00
8339 Root canal therapy – posteriors – first canal 1402.00
8340 Root canal therapy – posteriors – each additional canal 340.20
8341 Amalgam – one surface 336.40
8342 Amalgam – two surfaces 414.10
8343 Amalgam – three surfaces 504.90
8344 Amalgam – four or more surfaces 563.00
8345 Prefabricated post retention, per post (in addition to restoration) 288.70
8346 Restorative Material Factor 0.00
8347 Pin retention – first pin (in addition to restoration) 145.30
8348 Pin retention – each additional pin (in addition to restoration) 134.50
8349 Carve restoration to accommodate existing removable prosthesis 59.50
8350 Resin crown – anterior primary tooth (direct) 637.60
8351 Resin – one surface, anterior 368.90
8352 Resin – two surfaces, anterior 464.20
8353 Resin – three surfaces, anterior 554.40
8354 Resin – four or more surfaces, anterior 618.60
8355 Veneer – resin (chair-side) 509.50
8357 Prefabricated metal crown 299.50
8360 Interim (temporary) inlay/onlay 0.00
8361 Inlay – metal – one surface 446.00
8362 Inlay/onlay – metal – two surfaces 652.50
8363 Inlay/onlay – metal – three surfaces 1088.40
8364 Inlay/onlay – metal – four or more surfaces 1316.20
8366 Pin retention as part of cast restoration (any number of pins) 217.10
8367 Resin – one surface, posterior 400.00
8368 Resin – two surfaces, posterior 494.60
8369 Resin – three surfaces, posterior 597.70
8370 Resin – four or more surfaces, posterior 642.90
8371 Inlay – porcelain – one surface 537.70
8372 Inlay/onlay – porcelain – two surfaces 794.00
8373 Inlay/onlay – porcelain – three surfaces 1308.50
8374 Inlay/onlay – porcelain – four or more surfaces 1584.90
8375 Prefabricated resin crown 299.50
8376 Core build-up with prefabricated posts 799.60
8379 Cost of prefabricated posts Blank
8381 Inlay – resin – one surface 537.70
8382 Inlay/onlay – resin – two surfaces 794.00
8383 Inlay/onlay – resin – three surfaces 1308.50
8384 Inlay/onlay – resin – four or more surfaces 1584.90
8385 Fabrication of Indirect resin inlay/onlay restoration 0.00
8391 Cast core with single post 337.00
8392 Cast post (each additional) 200.60
8397 Cast core with pins (any number of pins) 537.70
8398 Core build-up with or without pins 652.50
8400 Temporary crown 0.00
8401 Crown – full cast metal 1929.20
8403 Crown – 3/4 cast metal 1929.20
8404 Crown – 3/4 porcelain/ceramic 1584.50
8405 Crown – resin laboratory 1584.50
8406 Crown – three-quarter resin (indirect) 1584.50
8407 Crown – resin with metal 1929.20
8409 Crown – porcelain/ceramic 1929.20
8410 Provisional crown 325.60
8411 Crown – porcelain with metal 1929.20
8413 Repair crown (permanent or provisional) 325.60
8414 Additional fee for provision of crown within an existing clasp or rest 97.00
8415 Pontic – porcelain/ceramic 1574.80
8416 Pontic – cast metal 1088.40
8417 Pontic – resin with metal 1574.80
8418 Pontic – porcelain fused to metal 1574.80
8419 Provisional pontic 325.60
8420 Pontic – resin based composite (indirect) 1574.80
8421 Temporary pontic 0.00
8423 Ovate pontic design 0.00
8431 Temporary inlay/onlay retainer 0.00
8432 Inlay/onlay retainer – metal – two surfaces 652.50
8433 Inlay/onlay retainer – metal – three surfaces 1088.40
8434 Inlay/onlay retainer – metal – four or more surfaces 1316.20
8436 Inlay/onlay retainer – porcelain – two surfaces 794.00
8437 Inlay/onlay retainer – porcelain – three surfaces 1308.50
8438 Inlay/onlay retainer – porcelain – four or more surfaces 1584.90
8440 Temporary crown retainer 0.00
8441 Crown retainer – full cast metal 1929.20
8442 Crown retainer – 3/4 cast metal 1929.20
8443 Crown retainer – porcelain/ceramic 1929.20
8444 Crown retainer – 3/4 porcelain/ceramic 1929.20
8445 Crown retainer – porcelain with metal 1929.20
8446 Crown retainer – resin with metal 1929.20
8447 Provisional crown retainer 325.60
8448 Crown retainer – resin based composite (indirect) 1929.20
8471 Procedural Sedation or General anaesthesia – assessment 0.00
8472 Procedural Sedation first 30 min 0.00
8473 Procedural Sedation each additional 15 min or part thereof 0.00
8474 Procedure room for sedation 0.00
8480 Cost of Prefabricated metal restoration 0.00
8481 Cost of prefabricated resin crown 0.00
8482 Cost of orthodontic attachment 0.00
8483 Cost of CT Scan DICOM conversion 0.00
8485 Cost of the production of a computer generated surgical guide using rapid prototyping.  Systems using computer generated   laboratory techniques (e.g. Med 3-D) can use laboratory technician  codes.(8099) 0.00
8499 General anaesthetic 0.00
8501 Consultation – Prosthodontis 0.00
8503 Occlusion analysis mounted 325.60
8505 Pantographic recording 473.00
8506 Detailed consultation – Prosthodontist 0.00
8507 Comprehensive consultation – Prosthodontist 0.00
8508 Electrognathographic recording 506.60
8509 Electrognathographic recording with computer analysis 841.20
8514 Recement bridge 146.80
8515 Sectioning of a bridge 0.00
8516 Remove bridge 292.40
8517 Reimplantation of avulsed tooth (include stabilisation) 339.30
8518 Repair bridge 325.60
8519 Fabrication of computer generated 1-3 surface resin or  ceramic inlay or onlay 0.00
8520 Fabrication of computer generated 4 or more surface resin or ceramic inlay or onlay 0.00
8521 Fabrication of computer generated resin or ceramic crown 0.00
8522 Fabrication of computer generated  resin or ceramic crown retainer, per unit as part of bridge framework 0.00
8523 Fabrication of computer generated  resin or ceramic pontic, per unit as part of bridge framework 0.00
8524 Fabrication of computer generated resin or  ceramic veneer for bridge framework, per unit 0.00
8525 Fabrication of computer generated ceramic implant supported restoration, per unit 0.00
8526 Fabrication of a computer generated ceramic implant abutment, per unit 0.00
8527 Direct Cost of material in the fabrication of computer generated resin restoration. See Rule 002 and Appendix A for the cost of direct materials 0.00
8528 Direct Cost of material in the fabrication of computer generated ceramic restoration. See Rule 002 and Appendix A for the cost of direct materials 0.00
8533 Implant supported removable complete overdenture 2634.50
8534 Implant supported removable partial overdenture 2107.20
8536 Crown – implant/abutment supported – porcelain/ceramic 2504.70
8537 Crown – implant/abutment supported – porcelain with metal 2504.70
8538 Crown – implant/abutment supported – cast metal 2504.70
8539 Crown-Implant / abutment supported crown – resin veneered to metal 2504.70
8541 Implant supported interim (temporary) crown – cemented A temporary implant supported crown is a short term acrylic or resin restoration that is made to maintain function and an appropriate transmucosal tissue aperture until the permanent prosthesis has be 0.00
8542 Implant supported interim (temporary) crown – screw retained 0.00
8543 Implant supported provisional crown – cemented 325.60
8544 Implant supported provisional crown – screw retained 325.60
8546 Crown retainer – implant/abutment supported – porcelain/ceramic 2504.70
8547 Crown retainer – implant/abutment supported – porcelain with metal 2504.70
8548 Crown retainer – implant/abutment supported – cast metal 2504.70
8549 Implant supported crown retainer – resin veneered to metal 1929.20
8550 Retainer-Implant/Abutment Supported 1929.20
8551 Occlusal adjustment – major 929.80
8552 Veneer – porcelain (laboratory) 1127.10
8553 Occlusal adjustment – minor 324.50
8554 Veneer – resin (laboratory) 1127.10
8560 Cost of ceramic block Blank
8561 Gold foil class I or IV 851.00
8563 Gold foil class V 995.50
8565 Gold foil class III 1252.50
8570 Fabrication of computer generated ceramic restoration 1680.90
8571 Implant supported interim (temporary) retainer – cemented 0.00
8572 Implant supported interim (temporary)crown  retainer – screw retained 0.00
8573 Implant supported provisional crown retainer – cemented 325.60
8574 Implant supported provisional crown retainer – screw retained 325.60
8578 Prefabricated abutment 272.70
8579 Custom abutment 1243.00
8580 Modification of prefabricated abutment 0.00
8581 Cast core with single post 0.00
8582 Cast core with double post 0.00
8583 Cast core with triple post 0.00
8584 Connector bar – implant supported 2634.50
8585 Connector bar 2634.50
8586 Stress breaker 982.40
8587 Coping metal 218.90
8590 Implant maintenance procedures – per implant 120.80
8591 Removal of implant supported prosthesis 292.40
8592 Crown – implant/abutment supported 0.00
8593 Repair of implant supported resin prosthesis 133.50
8594 Repair of implant supported prosthesis 133.50
8595 Repair of implant abutment 133.50
8596 Repair of implant supported ceramic or ceramometal crown, retainer or pontic 133.50
8597 Locks and milled rests 133.50
8598 Repair of implant supported Provisional Prosthesis 133.50
8599 Precision attachment (removable denture) 325.60
8600 Cost of implant components Blank
8601 Computerised implant planning 0.00
8602 Computer Generated Surgical Guide A computer generated surgical guide for implant positioning after computerised planning code 8601. See Rule 002 Code 8483 followed by 8092 0.00
8606 Placement of implant fixtures outside the oral cavity 1362.50
8607 Skeletal anchorage – screw, plate or implant 0.00
8608 Removal of non-integrated implant 724.40
8609 Flap operation with modification of the implant surface,including bone surgery-one to three implants per quadrant 0.00
8610 Flap operation with modification of the implant surface,including bone surgery-four or more implants per quadrant 0.00
8611 Pontic – sanitary 895.90
8612 Skeletal anchorage – removal 0.00
8613 Pontic – posterior 0.00
8615 Pontic – anterior/premolar 0.00
8617 Retainer cast metal (Maryland type retainer) 652.50
8618 Retainer – ceramic for resin bonded bridge 0.00
8621 Metal base for implant supported denture – Partial 0.00
8631 Root canal therapy – first canal 0.00
8633 Root canal therapy – each additional canal 0.00
8634 Apexification/ apexogenesis /recalcification – initial visit 0.00
8635 Apexification/recalcification  per visit 195.30
8637 Apicectomy/ periradicular surgery, first root – premolar 0.00
8638 Apicectomy/ periradicular surgery, each additional root – anteriors and premolars 0.00
8639 Endodontic instruments per patient per completed treatment. 0.00
8640 Removal of fractured post or instrument from root canal 0.00
8642 Apicectomy/ periradicular surgery, each additional root – molars 0.00
8643 Complete dentures – maxillary and mandibular (with complications) 0.00
8645 Complete dentures – maxillary and mandibular (with major complications) 0.00
8646 Immediate denture – maxillary or mandibular    Only for Prosthodontist 0.00
8647 Immediate denture – maxillary or mandibular (with major complications) Only for Prosthodontist 0.00
8649 Complete denture – maxillary or mandibular (with complications) 0.00
8651 Complete denture – maxillary or mandibular (with major complications) 0.00
8652 Overdenture – complete 2634.50
8653 Overdenture – partial 2107.20
8654 Implant supported fixed-detachable complete overdenture 2962.70
8655 Implant supported fixed-detachable partial overdenture 2369.80
8657 Replacement of precision attachment 186.80
8658 Interim complete denture 1461.10
8659 Interim partial denture 1168.60
8660 Additional fee to implant supported fixed-detachable denture – per implant 408.70
8661 Diagnostic dentures (including tissue conditioning) 2370.60
8662 Adjust complete or partial dentures (remounting) 379.90
8663 Metal base to complete denture 793.80
8664 Remount crown or bridge for prosthetics 379.90
8665 Mini screw implants 0.00
8666 Immediate loading of implant 0.00
8667 Soft base to denture (heat cured) 793.80
8668 Metal base for implant supported denture – complete 793.80
8669 Crown cemented on a screw-retained
implant-supported superstructure
2504.70
8670 Implant screw access closure 368.90
8671 Partial denture – cast metal framework with resin denture base 0.00
8672 Altered cast technique (in addition to partial denture) 101.90
8674 Additive partial denture 1195.10
8685 Modification of obturator prostheses per visit. 0.00
8701 Consultation – periodontist 0.00
8703 Consultation – Periodontist (detailed) 0.00
8705 Re-examination – Periodontist 0.00
8707 Periodontal screening – Periodontist 0.00
8711 The visualisation enhancement adjunct (VEA) 0.00
8713 Blood and Blood Products for Regeneration 0.00
8723 Provisional splinting – extracoronal (wire) – per sextant 272.70
8725 Provisional splinting – extracoronal (wire plus resin) – per sextant 395.70
8727 Provisional splinting – intracoronal – per tooth 124.30
8731 Incision & drainage of abscess – intra-oral 234.30
8732 Topical treatment of diseased soft tissue 0.00
8737 Root planing – four or more teeth per quadrant 588.40
8739 Root planing – one to three teeth per quadrant 468.10
8740 Periodontal maintenance 0.00
8741 Gingivectomy/gingivoplasty – four or more teeth per quadrant 767.50
8743 Gingivectomy or gingivoplasty – one to three teeth per quadrant 613.10
8746 Flap operation with root planing and curettage (open curettage) – four or more teeth per quadrant 0.00
8747 Flap operation with root planing and curettage, including bone surgery – one to three teeth per quadrant 0.00
8748 Flap operation with root planing and curettage, including bone surgery – four or more teeth per quadrant 0.00
8749 Flap procedure, root planing and one to three surgical services – per quadrant 1593.20
8751 Flap procedure, root planing and one to three surgical services – per sextant 1319.20
8753 Flap procedure, root planing and four or more surgical services – per quadrant 1974.70
8755 Flap procedure, root planing and four or more surgical services – per sextant 1600.30
8756 Clinical crown lengthening (isolated procedure) 970.50
8759 Pedicle flapped graft (isolated procedure) 729.10
8761 Masticatory mucosal autograft – one to four teeth (isolated procedure) 792.40
8762 Masticatory mucosal autograft – four or more teeth (isolated procedure) 1189.90
8763 Wedge resection (isolated procedure) 466.40
8765 Hemisection of a tooth, resection of a root or tunnel preparation (isolated procedure) 640.50
8766 Bone regeneration/repair procedure – as part of a flap operation 381.40
8767 Bone regeneration/repair procedure – at a single site 988.70
8768 Unlisted periodontal procedure 466.40
8769 Membrane removal (used for guided tissue regeneration) 466.40
8770 Cost of bone regenerative/repair material Blank
8771 Insertion of intra-pocket chemotherapeutic agent – per pocket so treated 0.00
8772 Submucosal connective tissue autograft (isolated procedure) 800.80
8773 Cost of intrapocket chemotherapeutic agent Blank
8774 Guided tissue regeneration – resorbable barrier, per site 0.00
8775 Guided tissue regeneration – nonresorbable barrier, per site (includes subsequent removal of membrane) 0.00
8776 Submucosal connective tissue autograft – extending across one to three teeth per quadrant 0.00
8777 Submucosal connective tissue autograft – extending across four or more teeth per quadrant 0.00
8778 Submucosal soft tissue allograft – extending across one to three teeth per quadrant 0.00
8779 Submucosal soft tissue allograft – extending across four or more teeth per quadrant 0.00
8780 Alveolar process preservation, per extraction site 0.00
8781 Consultation – Oral medicine (simple) 162.90
8782 Consultation – Oral medicine (complex) 0.00
8783 Consultation – Oral medicine (subsequent) 121.10
8785 Root resection 640.50
8786 Tunnel preparation 640.50
8787 Unlisted oral medicine procedure 167.20
8792 Vestibuloplasty with teeth per sextant 0.00
8793 Vestibuloplasty in an edentulous area per sextant 0.00
8794 Alveoplasty with implant therapy 1-3 teeth 0.00
8795 Alveoplasty with implant therapy 4 or more teeth 0.00
8796 Repair of oronasal opening 0.00
8801 Consultation – Orthodontist 200.70
8803 Consultation – Orthodontis (subsequent, retention and post treatment) 140.50
8804 Placement of Fixed orthodontic retainer 0.00
8805 Repair or Replacement of fixed orthodontic Retainer 0.00
8806 Orthodontic retention visit 0.00
8807 Post orthodontic treatment consultation 0.00
8811 Tracing and analysis of extra-oral film 45.10
8837 Diagnosis and treatment planning – Orthodontist 93.40
8839 Diagnostic setup (orthodontics) 199.70
8840 Treatment planning for orthognathic surgery – ALL 688.40
8841 Ortho Tx – fixed lingual appliance – one arch 10640.10
8842 Ortho Tx – fixed lingual appliance – one arch, modeate 12504.50
8843 Ortho Tx – fixed lingual appliance – one arch, severe 14247.20
8845 Temporary anchorage device per unit 0.00
8846 Repair orthodontic appliance – removable 134.80
8847 Replace orthodontic appliance – removable 466.40
8848 Repair orthodontic appliance – fixed 199.70
8849 Retainer (orthodontic) 466.40
8850 Treatment of MPDS – first visit 224.60
8851 Treatment of MPDS – subsequent visit 118.20
8852 Occlusal orthotic appliance 564.30
8855 Consultation – cleft palate therapy (house or hospital) 272.70
8856 Consultation – cleft palate (subsequent) 133.50
8857 Consultation – cleft palate (maximum) 931.10
8858 Ortho Tx – functional appliance 2968.90
8861 Ortho Tx – partial fixed appliance – minor 1974.70
8862 Ortho Tx – removable appliance 1648.00
8863 Ortho Tx – each additional removable appliance 828.40
8865 Ortho Tx – partial fixed appliance – one arch 5267.10
8866 Ortho Tx – partial fixed appliance – both arches 7243.90
8867 Ortho Tx – fixed appliance – one arch 5661.40
8868 Ortho Tx – fixed appliance – one arch, modeate 6983.30
8869 Ortho Tx – fixed appliance – one arch, severe 8167.50
8870 Therapy to control harmful habits – removable appliance 0.00
8871 Therapy to control harmful habits – fixed appliance 0.00
8873 Ortho Tx – fixed appliance – both arches, Class 1 mild 10360.40
8874 Ortho Tx – fixed lingual appliance – both arches, Class 1 mild 20297.90
8875 Ortho Tx – fixed appliance – both arches, Class 1 moderate 12718.80
8876 Ortho Tx – fixed lingual appliance – both arches, Class 1 moderate 23764.90
8877 Ortho Tx – fixed appliance – both arches, Class 1 severe 14826.60
8878 Ortho Tx – fixed lingual appliance – both arches, Class 1 severe 26970.40
8879 Ortho Tx – fixed appliance – both arches, Class 1 severe w/ complications 16662.30
8880 Ortho Tx – fixed lingual appliance – both arches, Class 1 severe w/ complications 29926.30
8881 Ortho Tx – fixed appliance – both arches, Class 2/3 mild 14826.60
8882 Ortho Tx – fixed lingual appliance – both arches, Class 2/3 mild 24774.90
8883 Ortho Tx – fixed appliance – both arches, Class 2/3 moderate 16662.30
8884 Ortho Tx – fixed lingual appliance – both arches, Class 2/3 moderate 27714.80
8885 Ortho Tx – fixed appliance – both arches, Class 2/3 severe 18704.80
8886 Ortho Tx – fixed lingual appliance – both arches, Class 2/3 severe 30867.60
8887 Ortho Tx – fixed appliance – both arches, Class 2/3 severe w/ complications 21074.70
8888 Ortho Tx – fixed lingual appliance – both arches, Class 2/3 severe w/ complications 34346.60
8889 Attachment device 0.00
8890 Monthly instalment ortho tx Blank
8891 Orthodontic transfer 0.00
8892 Orthodontic re-treatment 0.00
8893 Telephonic/electronic consultation 0.00
8894 Consultation without the patient (with family for consent or writing of special reports, or preparation of quotations ) 0.00
8895 Examination under general anesthesia 0.00
8896 Cost of materials required to aid eruption 0.00
8901 Consultation – MFOS 0.00
8902 Consultation – MFOS (detailed) 0.00
8903 House/Hosp/Nursing home consultation – MFOS 0.00
8904 House/Hosp/Nursing home consultation (subsequent) – MFOS 0.00
8905 After regularly hours consultation – MFOS 0.00
8906 Post-op visit in hospital for Neoplasm/Trauma/CLP (2x/day for duration of hospitalization), reported per visit 0.00
8907 House/Hosp/Nursing home consultation (maximum per week) – MFOS 0.00
8908 Surgical removal of roots from maxillary antrum 1941.00
8909 Oral antral fistula closure 1488.30
8910 Vermillionectomy 0.00
8911 Caldwell-Luc procedure 582.20
8912 Transmasseteric antero-parotid approach 0.00
8913 Condylar Risdon / submandibular approach 0.00
8914 Endoscopic or intra-oral approach to the condyle 0.00
8915 Intra-oral circum-oral mandibular approach 0.00
8916 Preauriculo-temporal approach 0.00
8917 Biopsy of oral tissue – soft 371.20
8918 Brush biopsy 0.00
8919 Biopsy of bone – needle 571.00
8920 Exfoliative cytological specimen collection 0.00
8921 Biopsy  extra-oral bone/soft tissue 934.70
8923 Aspiration biopsy (FNA) 574.60
8924 Open biopsy of a single lymphnode in the neck 0.00
8925 Biopsy of soft tissue –extraoral deep or intramuscular, requiring suturing in multiple layers 0.00
8926 Biopsy of tissue –intra-oral bone 934.70
8927 Biopsy of tissue –extra-oral bone 934.70
8928 Core Needle biopsy 574.60
8929 Removal of temperomandibular joint prosthesis 0.00
8930 Design meeting and/or planning for a custom prosthesis/tempero-mandibular joint, charge per joint/prosthesis designed 0.00
8931 Treatment of post-extraction haemorrhage 107.50
8932 Biopsy of soft tissue – intraoral superficial, with suturing 0.00
8933 Treatment of haemorrhage (blood dyscracias) 1488.30
8934 Biopsy of soft tissue– intraoral deep or intramuscular, requiring suturing in multiple layers 0.00
8935 Treatment of septic socket 107.50
8937 Surgical removal of tooth 635.00
8939 Limited neck dissection. 0.00
8940 Endoscopic management of a condylar fracture – report per side 0.00
8941 Surgical removal of impacted tooth – first tooth 1210.40
8943 Surgical removal of impacted tooth – second tooth 649.30
8944 Zygomatic fracture-open reduction with fixation at three or more sites 0.00
8945 Surgical removal of impacted tooth – third and subsequent teeth 369.20
8946 Zygomatic reconstruction (osteotomy or onlay) 0.00
8947 Anthrostomy for the placement of a sinuspack in order to reduce a zygomatic fracture 0.00
8948 Endoscopic procedure: Wharton’s duct 0.00
8949 Endoscopic procedure: Stenson’s duct 0.00
8950 Excision of a ranula (marsupealization) 0.00
8951 Trigger point injection (local anesthesia) 0.00
8952 Pain point injection (alcohol, phenol, etc) 0.00
8953 Surgical removal of residual roots, first tooth – per tooth 0.00
8954 Laser treatment for facial pain 0.00
8955 Alveoplasty or alveolectomy in conjunction with extractions per quadrant 0.00
8956 Alveoplasty or alveolectomy not in conjunction with extractions – per quadrant 0.00
8957 Alveolotomy or alveolectomy (including extractions) 779.30
8958 Emergency tracheotomy 654.90
8959 Pharyngostomy 654.90
8960 Salivary duct dilatation or canalization 0.00
8961 Tooth transplantation 1277.60
8962 Harvest iliac crest graft 471.00
8963 Harvest rib graft 540.30
8964 Harvest cranium graft 423.40
8965 Peripheral neurectomy 1277.60
8966 Repair of oronasal fistula (local flaps) 1777.40
8967 Surgical removal of jaw cyst – intra-oral approach 1774.80
8968 Excision of benign soft tissue tumour requiring extensive resection and suturing in multiple layers with  muscular involvement 0.00
8969 Surgical removal of jaw cyst – extra-oral approach 2843.40
8970 Excision of benign soft tissue tumour requiring suturing in multiple layers no muscular involvement 0.00
8971 Excision of tumour of the soft tissue 571.00
8972 Excision small malignant lesion requiring minimal suturing 0.00
8973 Surgical excision of tumours of the jaw 2843.40
8974 Excision of malignant soft tissue tumour requiring suturing in multiple layers no muscular or intraosseus involvement 0.00
8975 Hemiresection of jaw excluding condyl 2986.60
8976 Extensive resection for malignant soft tissue tumour – excluding reconstruction 0.00
8977 Surgical repair of maxilla or mandible – major 2984.40
8978 Excision of a lesion of the tongue requiring no suture or primary suture, excludes primary suture and may be reported with code 8990 0.00
8979 Harvesting of autogenous grafts (intra-oral) 246.10
8980 Intraoral harvesting of bone-coagulum/bone-scraping, not per site 0.00
8981 Surgical exposure of impacted or unerupted teeth to aid eruption 1172.70
8982 Local excision of benign lesion of lip with primary closure 0.00
8983 Corticotomy – first tooth 848.40
8984 Corticotomy – each additional tooth 430.10
8985 Frenulectomy/frenulotomy 779.30
8986 Local excision of benign lesion of lip where primary closure is not possible.  The appropriate code for the reconstruction should be reported. 0.00
8987 Reduction of mylohyoid ridges – per side 1277.60
8988 Resection for lip malignancy – excludes closure or reconstruction 0.00
8989 Removal torus mandibularis 1277.60
8990 Repair by primary suture 0.00
8991 Removal of torus palatinus 1277.60
8992 Repair by skin graft or local flap 0.00
8993 Surgical reduction of osseous tuberosity – per side 571.00
8994 Placement of Zygomaticus implant 0.00
8995 Gingivectomy – per jaw 1136.60
8996 Placement of  a second Zygomaticus implant 0.00
8997 Sulcoplasty / Vestibuloplasty 2929.20
8998 Craniofacial transcutaneous endosseus implant 0.00
8999 Craniofacial transmucosal endosseus implant 0.00
9001 Augmentation of alveolar ridge using block graft / split ridge technique – across one to two tooth sites 581.20
9002 Augmentation of alveolar ridge using block graft / split ridge technique – across three to five tooth sites 1291.80
9003 Reposition mental foramen and nerve – per side 1774.80
9004 Lateralization of inferior dental nerve 2859.90
9005 Alveolar ridge augmentation – total (by bone graft) 2986.60
9006 Lip reconstruction following an injury or tumour removal: primary closure 0.00
9007 Alveolar ridge augmentation – total (by alloplastic material) 1880.10
9008 Alveolar ridge augmentation – one to two tooth sites 581.20
9009 Alveolar ridge augmentation – three across 3 or more tooth sites 1291.80
9010 Sinus lift procedure 1941.00
9011 Incision & drainage of abscess – intra-oral (pyogenic) 363.40
9012 Maxillary sinus floor bone augmentation, buccal-approach, limited 0.00
9013 Incision & drainage of abscess – extra-oral (pyogenic) 496.90
9014 Osteotome sinus floor bone augmentation 0.00
9015 Apicectomy – anteriors (including retrograde filling) 724.40
9016 Apicectomy – posteriors (including retrograde filling) 1277.60
9017 Decortication, saucerisation and sequestrectomy 2630.30
9018 Lip reconstruction following an injury or tumour removal: simple advancement, rotation flap (Abbe or Estlander) (first stage) 0.00
9019 Sequestrectomy – intra oral per sextant and or ramus 571.00
9020 Lip reconstruction following an injury or tumour removal: simple advancement, rotation flap (Abbe or Estlander) (subsequent stages) 0.00
9021 Suture – reconstruction, minor (excludes closure of surgical incisions) 724.40
9022 Lip reconstruction following an injury or tumour removal: Total complicated reconstruction with a complicated advancement flap (Bernard flap) 0.00
9023 Suture – reconstruction, major (excludes closure of surgical incisions) 1348.00
9024 Dento-alveolar fracture – per sextant 640.50
9025 Mandible fracture – closed reduction 1418.70
9026 Radical neck dissection 0.00
9027 Mandible fracture – compound, with eyelet wiring 1992.20
9028 Modified radical neck dissection 0.00
9029 Mandible fracture – splints 2205.90
9030 Selective neck dissection . 0.00
9031 Mandible fracture – open reduction 3270.00
9032 Reduction of masseter muscle and bone – extra-oral approach 0.00
9033 Reduction of masseter muscle and bone – intra-oral approach 0.00
9034 Extended neck dissection. 0.00
9035 Maxilla fracture – Le Fort I or Guerin 1995.90
9036 Open treatment of maxillary fracture – Le Fort I 0.00
9037 Maxilla fracture – Le Fort II or middle third face 3270.00
9038 Open treatment of maxillary fracture – II or middle third of face 0.00
9039 Maxilla fracture – Le Fort III or craniofacial disjunction 4689.40
9040 Surgical removal of jaw cyst/tumor – intra-oral approach for lesions  >1cm with no involvement of vital structures 0.00
9041 Zygomatic arch fracture – closed reduction 1418.70
9042 Surgical removal of jaw cyst/tumor – intra-oral approach for lesions  >1cm with involvement of vital structures, reconstructive procedures not included 0.00
9043 Zygomatic arch fracture – open reduction 2843.40
9044 Surgical excision of malignant tumours of the jaws– extra-oral approach, reconstructive procedures not included 0.00
9045 Zygomatic arch fracture – open reduction (requiring osteosynthesis and/or grafting) 4259.50
9046 Placement of Zygomaticus fixture, per fixture 2813.90
9047 Osteotomy – open with stabilisation 5961.20
9048 Surgical removal of internal fixation devices, per site 546.50
9049 Osteotomy – mandible body, anterior segmental 4968.30
9050 Osteotomy – total subapical 9088.20
9051 Genioplasty 2843.40
9052 Midfacial exposure 4500.70
9053 Coronoidectomy (intra-oral approach) 1773.70
9054 Surgical excision of tumours of the midface (zygoma, nose and orbits), reconstructive procedures not included 0.00
9055 Osteotomy – segmented, posterior 4968.30
9056 Radical resection of palate (including skin graft) 0.00
9057 Osteotomy – segmented, anterior 4968.30
9058 Wide excision of lesion of palate 0.00
9059 Reconstruct maxilla – Le Fort I osteotomy, one piece 9348.40
9060 Reconstruct maxilla – Le Fort I osteotomy w/ repositioning and graft 10494.50
9061 Palatal osteotomy 3270.00
9062 Reconstruct maxilla – Le Fort I osteotomy, multiple segments 11933.60
9063 Reconstruct maxilla – Le Fort 2 osteotomy (facial and post-traumatic deformities) 11939.50
9064 Complicated reconstruction of bony defects following major ablative procedure for head and neck cancer – soft tissue reconstruction excluded 0.00
9065 Reconstruct maxilla – Le Fort 3 osteotomy (severe congenital deformities) 17893.40
9066 Surgical expansion – maxilliary or mandibular 2843.40
9067 Distraction osteogenesis – across one to two tooth sites 0.00
9068 Distraction of the alveolar ridge (across 3-5 tooth sites) 0.00
9069 Glossectomy – partial 2129.50
9070 Distraction of the alveolar ridge (full arch) 0.00
9071 Geniohyoidotomy 1277.60
9072 Close secondary oro-nasal fistula w/ bone grafting (complete procedure) 9348.40
9073 Distraction for the reconstruction of the mandibular body (per side) 0.00
9074 Tmj arthroscopy diagnostic 1411.40
9075 Condylectomy, coronoidectomy or both 3545.70
9076 TMJ artrocentesis 779.30
9077 TMJ intra-articular injection 212.60
9078 Distraction for the reconstruction of the mandibular condyle and tempero-mandibular joint 0.00
9079 Trigger point injection 165.90
9080 Distraction for the reconstruction of the midface (internal distractor) 0.00
9081 Condylectomy (Ward/Kostecka) 1418.70
9082 Distraction for the reconstruction of the midface (external distractor) 0.00
9083 TMJ srthroplasty 3545.70
9084 Removal of an internal or external distractor device 0.00
9085 Reduction of TMJ disloc w/o anaesthetic 282.10
9086 Tumour resection from infratemporal or pterygopalatine fossa 0.00
9087 Reduction of TMJ disloc w/ anaesthetic 571.00
9088 Tarsorrhaphy 0.00
9089 Reduction of TMJ disloc w/ anaesthetic and immobobilisation 1418.70
9090 Excision of lacrimal sac: Unilateral 0.00
9091 Reduction of TMJ dislocation – open reduction 3545.70
9092 Joint reconstruction 9466.60
9093 Removal of salivary stone (Sialolithotomy) 640.50
9094 Orbitectomy: Removal of tumour 0.00
9095 Excision of sublinglual salivary gland 1578.90
9096 Excision of salivary gland – extra oral approach 2338.90
9097 Orbit: Exenteration 0.00
9098 Partial mandibulectomy 0.00
9099 Unlisted dental procedure or service (By report) 0.00
9100 Multiple extra-oral incision & drainages (eg. Ludiwig’s angina) 0.00
9101 Obturator prosthesis, surgical – modified denture 196.30
9102 Obturator prosthesis, surgical – continuous base 531.70
9103 Obturator prosthesis, surgical – split base 792.40
9104 Obturator prosthesis, interim – on existing denture 1195.10
9105 Obturator prosthesis, interim – on new denture 3691.00
9106 Obturator prosthesis, definitive – open/hollow box 1195.10
9107 Obturator prosthesis, definitive – silicone glove 2307.60
9108 Mandibular resection prosthesis w/ guide flange 2834.80
9109 Mandibular resection prosthesis w/o guide flange 2634.50
9110 Mandibular resection prosthesis, palatal augmentation 531.70
9111 Glossal resection prosthesis – simple 1109.20
9112 Glossal resection prosthesis – complex 1661.40
9113 Radiation carrier – simple 1195.10
9114 Radiation carrier – complex 3298.60
9115 Radiation shield – simple 1195.10
9116 Radiation shield – complex 3298.60
9117 Radiation cone locator 1195.10
9118 Chemotherapeutic agent carrier 1195.10
9119 Feeding aid prosthesis, neonatal 1057.90
9120 Orthopaedic appliance, active presurgical – minor 1057.90
9121 Orthopaedic appliance, active presurgical – moderate 1565.60
9122 Orthopaedic appliance, active presurgical – severe 2634.50
9123 Orthopaedic appliance, active presurgical – modification

133.50
9124 Mandibular Advancement Device 2800.90
9125 Speech aid/obturator prosthesis – palatal alteration 532.80
9126 Speech aid/obturator prosthesis – velar alteration 1195.10
9127 Speech aid/obturator prosthesis – pharyngeal alteration 2634.50
9128 Speech aid/obturator prosthesis – modification 133.50
9129 Speech aid/obturator prosthesis – surgical 1057.90
9130 Speech aid appliance – palatal lift 531.70
9131 Speech aid appliance – palatal stimulating 1195.10
9132 Speech aid appliance – bulb 2634.50
9133 Speech aid appliance – modification 133.50
9134 Unspecified speech aid appliance Blank
9135 Auricular prosthesis – simple 3298.60
9136 Auricular prosthesis – complex 4303.50
9137 Nasal prosthesis – simple 3298.60
9138 Nasal prosthesis – complex 4303.50
9139 Ocular prosthesis – interim 1195.10
9140 Ocular prosthesis – modified stock appliance 2965.00
9141 Ocular prosthesis – custom appliance 4303.50
9142 Orbital prosthesis – simple 2965.00
9143 Orbital prosthesis – complex 4303.50
9144 Facial prosthesis, combination – small Blank
9145 Facial prosthesis, combination – medium Blank
9146 Facial prosthesis, combination – large Blank
9147 Facial prosthesis, combination – complex Blank
9148 Unspecified body prosthesis – simple 2965.00
9149 Unspecified body prosthesis – complex 4303.50
9150 Facial prosthesis, surgical – simple 2307.60
9151 Facial prosthesis, surgical – complex 2965.00
9152 Extraoral appliance – additional prosthesis Blank
9153 Extraoral appliance – replacement prosthesis Blank
9154 Cost of Surgical Splint 0.00
9155 Cranial prosthesis 1195.10
9156 Cranial implant prosthesis, custom made 1442.90
9157 Facial implant prosthesis, custom made – simple 720.90
9158 Facial implant prosthesis, custom made – complex 1442.90
9159 Ocular implant prosthesis, custom made 720.90
9160 Body implant prosthesis – custom made 3207.50
9161 Surgical splint – simple 325.60
9162 Surgical splint – complex 1195.10
9163 Surgical template – simple 325.60
9164 Surgical template – complex 1195.10
9165 Surgical conformer – simple 325.60
9166 Surgical conformer – complex 1195.10
9167 Trismus appliance (simple) 133.50
9168 Trismus appliance (complex) 1195.10
9169 Orthoses appliance 2634.50
9170 Facial palsy appliance 792.40
9171 Commissure splint 325.60
9172 Oral retractor, dynamic – per arm 325.60
9173 Hand splint 0.00
9174 Unspecified burn appliance 0.00
9175 Theatre attendance (MaxFac prosthod) /hour 440.60
9176 Local resection of parotid tumour (lumpectomy) 0.00
9177 Superficial parotidectomy 0.00
9178 Total parotidectomy with preservation of facial nerve 0.00
9179 Total parotidectomy without preservation of facial nerve 0.00
9180 Surgical placement of sub-periosteal implant – preparatory stage 1933.70
9181 Surgical placement of sub-periosteal implant – placement stage 1933.70
9182 Surgical placement of endosteal implant plate 968.00
9183 Surgical placement of endosteal implant – first per jaw 1362.50
9184 Surgical placement of endosteal implant – second per jaw 1020.00
9185 Surgical placement of endosteal implant – third and subsequent per jaw 682.90
9186 Closure of salivary fistula 0.00
9187 Cost of endosteal implant body Blank
9188 Cost of prefabricated abutment Blank
9189 Cost of other implant compnts Blank
9190 Surgical placement of abutment – first per jaw 505.60
9191 Surgical placement of abutment – second per jaw 379.70
9192 Surgical placement of abutment – third and subsequent per jaw 254.20
9193 Report as an additional code for the placement of endosseus implant into fresh extraction socket 0.00
9194 Surgical placement of one-piece transmucosal endosseus implant 0.00
9195 Report as an additional code for the surgical placement of single phase endosseus implant 0.00
9196 Planning for Craniofacial Reconstruction – Simple 0.00
9197 Planning for Craniofacial Reconstruction – Complex 0.00
9198 Surgical removal of implant 629.80
9200 Cranioplasty 0.00
9201 Consultation – oral pathologist 0.00
9202 Excision of submandibular salivary gland with any type of neck dissection 0.00
9203 House/Hosp/Nursing home consultation – Oral pathologist 0.00
9204 Sandwich osteotomy – for placement of an interpositional bone graft to increase the alveolar ridge height, may also be reported if utilized in the maxilla 0.00
9205 Consultation – oral pathologist (subsequent) 0.00
9206 Surgical removal of reconstruction plate 0.00
9207 After hours visit – Oral pathologist 0.00
9208 Harvest iliac crest graft – monocortical 0.00
9209 Harvest iliac crest graft – bicortical 0.00
9210 Harvest tibial bone – spongiosa 0.00
9211 Harvest iliac crest graft – bicortical 0.00
9212 Harvest rib graft – bone 0.00
9213 Harvest rib graft – cartilage 0.00
9214 Harvest auricular cartilage graft 0.00
9215 Intra-oral harvesting of particulate bone 0.00
9216 Harvest fascia lata 0.00
9217 Harvest of free fat 0.00
9218 Nerve repair: 1st Fasciculus 0.00
9219 Nerve repair: 2nd and additonal Fasciculus 0.00
9220 Repair cleft hard palate – unilateral 5221.20
9222 Repair cleft hard palate – bilateral (one procedure) 6628.60
9223 Ligation of maxillary artery 0.00
9224 Repair cleft hard palate – bilateral (two procedures) 9876.60
9225 Nerve repair: entubelation 0.00
9226 Repair cleft soft palate – w/o muscle reconstruction 4375.60
9227 Turbinectomy 0.00
9228 Repair cleft soft palate – w/ muscle reconstruction 6353.20
9229 Choanal artesia repair through a palatal osteotomy 0.00
9230 Repair submucosal cleft and/or bifid uvula – w/ muscle reconstruction 4730.40
9232 Velopharyngeal reconstruction – uncomplicated 4867.60
9233 Obliteration of the frontal sinus 0.00
9234 Velopharyngeal reconstruction – complicated 5205.20
9235 Severe nasal bleeding – anterior pack 0.00
9236 Severe nasal bleeding – anterior + posterior pack or cauterization 0.00
9237 Management of a patient on anti-coagulatives for the performance of a surgical procedure, this code is reported along with the appropriate surgical codes 0.00
9238 Repair oronasal fistula (one procedure) 2977.30
9239 Surgical facility for surgical procedures in consulting rooms 0.00
9240 Repair oronasal fistula (two procedures) 5193.70
9241 Simple local flap (eg. Advancement or rotation flap) 0.00
9242 Complex local flap 0.00
9243 Regional flap (eg pectoral, deltoid or lattisimus dorsi flap) 0.00
9244 Tongue flap – 2 procedures 0.00
9245 Muscle spasm injection (Botulinum toxin) – excludes the cost for the Botulinum toxin (code 8183) 0.00
9246 Secondary periosteal flaps 2595.70
9247 Bicoronal approach 0.00
9248 Lipadhesion 970.50
9249 Blephro-approach 0.00
9250 Repair cleft lip – unilateral w/o muscle reconstruction 1709.20
9251 Transconjunctival/subcilliary approach 0.00
9252 Repair cleft lip – unilateral w/ muscle reconstruction 2317.00
9253 Mandibular swing approach for access to the skullbase 0.00
9254 Repair cleft lip – bilateral w/o muscle reconstruction 2386.60
9255 Geniohyoidotomy (mandibular split) 0.00
9256 Repair cleft lip – bilateral w/ muscle reconstruction 3687.30
9257 Midfacial deglove, including nasal skeleton 0.00
9258 Repair anterior nasal floor 931.10
9259 Distraction device for alveolar bone 0.00
9260 Revision of secondary cleft lip deformity – partial 931.10
9261 Internal distraction device for maxilla or mandible 0.00
9262 Revision of secondary cleft lip deformity – total w/ muscle reconstruction 2103.70
9263 Transport distraction device 0.00
9264 Abbe-flap – two stages 2381.90
9265 External distraction device for maxilla or mandible 0.00
9266 Reconstruct columella 1408.10
9267 Temperomandibular joint prosthesis (stock or custom) 0.00
9268 Reconstruct nose due to cleft deformity – partial 1789.20
9269 Custom prosthesis for facial reconstruction 0.00
9270 Reconstruct nose due to cleft deformity – complete 2827.60
9271 Cost of impression material (only to be used with code 8215 0.00
9272 Paranasal augmentation for nasal base deviation 1408.10
9273 Open treatment of an orbital wall fracture 0.00
9274 Repair anterior table, frontal sinus and/or supraorbital rim 0.00
9275 Major orbital reconstruction (comminuted orbital fractures) 0.00
9276 Repair anterior and posterior wall w/ obturation and/or cranialisation of frontal sinus 0.00
9277 Secondary reconstruction of orbital defect 0.00
9278 Repair medial canthal ligament (canthopexy), per side 0.00
9279 Eyelid surgery for facial paralysis including tarsoraphy (excludes material) 0.00
9280 Open reduction and fixation of nasal fractures 1830.50
9281 Full thickness eyelid repair (tumor or trauma surgery) 0.00
9282 Manipulation and immobilisation of nasal fracture 995.80
9283 Repair by superior rectus, levator or frontalis muscle operation 0.00
9284 Musculofascial flap 0.00
9285 Ptosis: By lesser procedure e.g. sling operation 0.00
9286 Musculocranial flap 0.00
9287 Dacrocystorhinostomy 0.00
9288 Buccal fat pad (major repair) 0.00
9289 Frenulotomy 0.00
9290 Maxillectomy – Alveolus only, Level I 0.00
9291 Zygomatic fracture-open reduction with fixation at two sites 0.00
9292 Maxillectomy – Alveolus and sinus or nasal floor, Level II 0.00
9293 Zygomatic fracture-closed reduction 0.00
9294 Maxillectomy – Alveolus, sinus, nasal floor and zygoma excluding orbital rim Level III 0.00
9296 Maxillectomy – Alveolus, sinus, nasal floor and zygoma including orbital rim Level IV 0.00
9298 Maxillectomy – Alveolus, sinus, nasal floor, zygoma, orbital rim and pterygoid plates Level V 0.00
9299 Abscess – Retropharyngeal or equivalent 0.00
9300 Hemiresection of jaw including condyle and coronoid process 0.00