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

1082.54

1623.73

-

Mandibular Fractures

9025

Treatment by closed reduction,with intermaxillary fixation

M

S

2401.81

3602.53

-

9027

Treatment of compound fracture, involving eyelet wiring

M

S

3371.55

5057.08

-

9029

Treatment by metal cap splintage or Gunning's splints

+L

M

S

3737.75

5606.34

-

9031

Treatment by open reduction with restoration of occlusion by splintage

+L

M

S

5535.12

8302.27

-

8940

Endoscopic management of a condylar fracture - report per side

S

1824.79

2736.46

-

Mandibulectomy / mandibulotomy

9098

Partial mandibulectomy

S

-

6067.95

-

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

3379.65

5069.22

-

9036

Open treatment of maxillary fracture - Le Fort I

+L

S

2566.86

3850.23

-

9037

Le Fort II or middle third of face fracture

+L

S

5535.12

8302.27

-

9038

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

+L

S

4205.18

6307.60

-

9039

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

+L

M

S

7934.97

11901.87

-

Zygoma / Orbit / Antral - complex fractures

9041

Zygomatic arch fracture - closed reduction

Gillies or temporal elevation

S

2401.81

3602.53

-

9043

Zygomatic arch fracture - open reduction

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

S

4810.99

7216.12

-

9045

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

S

7212.48

10818.18

-

9291

Zygomatic fracture - open reduction with fixation at two sites

S

3656.28

5484.31

-

8944

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

S

3656.28

5484.31

-

9293

Zygomatic fracture - closed reduction

S

1824.79

2736.46

-

8946

Zygomatic reconstruction (osteotomy or onlay)

S

7666.28

11499.75

-

8947

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

S

-

1592.51

-

9046

Placement of zygomaticus fixture, per fixture

S

6032.30

9048.00

-

9273

Open treatment of an orbital wall fracture

S

-

3500.42

-

9275

Major orbital reconstruction (comminuted orbital fractures)

S

-

3500.42

-

9277

Secondary reconstruction of orbital defect

S

-

3500.42

-

9279

Eyelid surgery for facial paralysis including tarsoraphy (excludes material)

S

-

4610.18

-

9283

Repair by superior rectus, levator or frontalis muscle operation

S

-

4683.61

-