Code

Procedure description

DM/+L

MP

TC

General Dental Practice

(054)

Maxillo-facial and Oral Surgery

(062)

Prosthodontics

(094)

TREATMENT OF FRACTURES

Alveolus Fractures

9024

Dento - alveolar fracture, per sextant

+L

S

S

1021.26

1531.82

-

Mandibular Fractures

9025

Treatment by closed reduction,with intermaxillary fixation

M

S

2265.85

3398.61

-

9027

Treatment of compound fracture, involving eyelet wiring

M

S

3180.71

4770.83

-

9029

Treatment by metal cap splintage or Gunning's splints

+L

M

S

3526.18

5289.00

-

9031

Treatment by open reduction with restoration of occlusion by splintage

+L

M

S

5221.81

7832.33

-

8940

Endoscopic management of a condylar fracture - report per side

S

1721.50

2581.56

-

Mandibulectomy / mandibulotomy

9098

Partial mandibulectomy

S

-

5724.48

-

Maxillary fractures with special attention to occlusion

Please Note: When open reduction is required for tariff codes 9035 and 9037, Modifier 8010 may be applied

9035

Le Fort I or Guerin fracture

+L

S

3188.35

4782.28

-

9036

Open treatment of maxillary fracture - Le Fort I

+L

S

2421.57

3632.29

-

9037

Le Fort II or middle third of face fracture

+L

S

5221.81

7832.33

-

9038

Open treatment of maxilla fracture - Le Fort II or middle third face

+L

S

3967.15

5950.57

-

9039

Le Fort III or craniofacial dislocation or comminuted mid-facial fractures requiring open reduction and splintage

+L

M

S

7485.82

11228.18

-

Zygoma / Orbit / Antral - complex fractures

9041

Zygomatic arch fracture - closed reduction

Gillies or temporal elevation

S

2265.85

3398.61

-

9043

Zygomatic arch fracture - open reduction

Unstable and/or comminuted zygoma fractures, treatment by open reduction or Caldwell-Luc operation

S

4538.67

6807.66

-

9045

Zygomatic arch fracture - open reduction (requiring osteosynthesis and/or grafting)

S

6804.23

10205.83

-

9291

Zygomatic fracture - open reduction with fixation at two sites

S

3449.32

5173.88

-

8944

Zygomatic fracture - open reduction with fixation at three or more sites

S

3449.32

5173.88

-

9293

Zygomatic fracture - closed reduction

S

1721.50

2581.56

-

8946

Zygomatic reconstruction (osteotomy or onlay)

S

7232.34

10848.82

-

8947

Anthrostomy for the placement of a sinuspack in order to reduce a zygomatic fracture

S

-

1502.37

-

9046

Placement of zygomaticus fixture, per fixture

S

5690.85

8535.85

-

9273

Open treatment of an orbital wall fracture

S

-

3302.29

-

9275

Major orbital reconstruction (comminuted orbital fractures)

S

-

3302.29

-

9277

Secondary reconstruction of orbital defect

S

-

3302.29

-

9279

Eyelid surgery for facial paralysis including tarsoraphy (excludes material)

S

-

4349.23

-

9283

Repair by superior rectus, levator or frontalis muscle operation

S

-

4418.68

-