Fee Schedule
The following is a list of ADA procedure codes with the associated fee ranges. I find that it is best for the patient to have both the exact fee for the procedure, as well as the financial arrangements made prior to scheduling any appointments with our office. There are several ways to accomplish these goals. We may need to discuss these issues together to find what works best for your practice.
|
Code |
Description |
Fee Ranges |
| 7140 | Single Extraction | $270-340.00 |
| 7210 | Surgical Extraction | 300-370.00 |
| 7220 | Soft Tissue Impaction | 325-375.00 |
| 7230 | Partial Bony Impaction | 370-425.00 |
| 7240 | Complete Bony Impaction | 425-495.00 |
| 7241 | Complicated Bony Impaction | 495-585.00 |
| 7250 | Surgical Root Removal | 295-375.00 |
| 6010 | Dental Implant Placement | 1720-2100.00* |
| 7310 | Alveoloplasty, with Extraction | 390.00 |
| 7320 | Alveoloplasty, per Quad, without Extraction | 555.00 |
| 7953 | Ridge Preservation | 450.00 |
| 7960 | Frenectomy | 545.00 |
| 4266 | Membrane Placement (each site) | 250.00* |
| 7470 | Removal of Tori or Exostosis | 820.00 |
| 9230 | Nitrous Oxide | 85.00 |
| 9310 | Consultation | 58.00/0.5 hr. |
| 9610 | Therapeutic Drug Injection (2 or more Decadron) | 109.00 |
| See Box Below | IV (Conscious) Sedation--One Hour | 600.00 |
Typical Coding for One (1) Hour of IV Sedation
Please assume each IV case to be one hour, unless I advise you differently.
| 9239 | IV Sedation, first 15 minutes | $165.00 |
| 9243 | IV Sedation, each addl. 15 minutes | $145.00 |
| 9243 | IV Sedation, each addl. 15 minutes | $145.00 |
| 9243 | IV Sedation, each addl. 15 minutes | $145.00 |
|
One (1) Hour IV Sedation = $600.00 |
||
Routine Wisdom Teeth Cases
| Total Fee Range | Procedure |
| $1809-2840.00 | Four 3rds extraction with IV sedation |
| $1450-2590.00 | Four 3rds extraction with oral pre-medication |
| $1285-2425.00 | Four 3rds extraction with local anesthesia/nitrous |
In determining the total fee to present to the patient for routine wisdom teeth cases, choose a fee that fits into the above ranges. In choosing a fee within the fee range, take into consideration the following two factors: 1) the apparent difficulty of the extraction; and, 2) the patient's age. As the difficulty increases, and as the patient's age increases over 25, choose a higher fee.