III

SPECIALIST MAXILLO-FACIAL AND ORAL SURGEONS

(M) See Rule 009

Code

Procedure description

Rc

MP

Fee

REMOVAL OF TEETH

Modifier 8002 is applicable to codes 8201 and 8202

Extractions during a single visit

8201

Single tooth

Code 8201 is charged for the first extraction in a quadrant

196.42

T

8202

Each additional tooth in the same quadrant

Code 8202 is charged for each additional extraction in the same quadrant

90.30

T

8957

Alveolotomy or alveolectomy - concurrent with or independent of extractions (per jaw)

1759.05

8961

(M/W)

Auto-transplantation of tooth

(See Rule 011 and Notes 2 and 3)

2883.43

+L

8931

Local treatment of post-extraction haemorrhage (excluding treatment of bleeding in the case of blood dyscrasias, e.g. haemophilia)

965.42

8933

Treatment of haemorrhage in the case of blood dyscrasias, e.g. hemophilia, per week

3425.19

8935

Treatment of post-extraction septic socket where patient is referred by another registered practitioner

255.67

8937

Surgical removal of erupted tooth requiring elevation of mucoperiosteal flap, removal of bone and/or other section of tooth

891.34

Includes cutting of gingiva and bone, removal of tooth structure and closure.

Code 8220 is applicable when suture material is provided by the practitioner (Rule 013)

Removal of roots

Code 8220 is applicable when suture material is provided by the practitioner (Rule 013)

8953

Surgical removal of residual tooth roots (cutting procedure)

Includes cutting of gingiva and bone, removal of tooth structure and closure

1281.75

T

8955

(M/W)

Surgical removal of residual tooth roots (cutting procedure), each subsequent tooth

Includes cutting of gingiva and bone, removal of tooth structure and closure

(See Rule 011 and Notes 2 and 3)

na/nvt

T

Unerupted or impacted teeth

8941

First tooth

2123.23

T

8943

Second tooth

1140.41

T

8945

Third tooth

651.48

T

8947

Fourth and subsequent tooth

651.48

T