I

GENERAL DENTAL PRACTITIONERS

Code

Procedure description

Rc

Fee

MP

Refer to the specialist maxillo-facial and oral surgeon schedule for surgical services not listed in this schedule

Extractions

8201

Single tooth

Code 8201 is charged for the first extraction in a quadrant

196.82

T

8202

Each additional tooth in the same quadrant

276.10

T

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

Surgical extractions (includes routine postoperative care)

8209

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

605.04

T

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

8210

Removal of unerupted or impacted tooth - first tooth

1415.89

T

8211

Removal of unerupted or impacted tooth - second tooth

760.01

T

8212

Removal of unerupted or impacted tooth - each additional tooth

432.66

T

8213

Surgical removal of residual tooth roots (cutting procedure)

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

872.91

T

8214

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

537.95

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

Other surgical procedures

8188

Biopsy - intra-oral

476.11

This item does not include the cost of the essential pathological evaluations

Repair of traumatic wounds

8192

Appositioning (i.e., suturing) of soft tissue injuries

986.25