Procedure Code |
Procedure Description |
Fee |
8091 |
Medicine used during a dental visit |
|
8092 |
Admin fee (direct material) |
|
8093 |
Dentist administration of Dental Technician’s account |
|
8099 |
Dental laboratory service |
|
8101 |
Oral examination |
224.50 |
8102 |
Comprehensive oral examination |
336.90 |
8104 |
Limited oral examination |
108.80 |
8106 |
Special report |
214.10 |
8107 |
Intraoral radiograph – periapical |
97.30 |
8108 |
Intraoral radiographs – complete series |
653.70 |
8109 |
Infection control/barrier techniques |
21.60 |
8110 |
Sterilized instrumentation |
48.40 |
8111 |
Dental testimony |
|
8112 |
Intraoral radiograph – bitewing |
97.30 |
8113 |
Intraoral radiograph – occlusal |
145.50 |
8114 |
Extraoral radiograph – hand-wrist |
337.60 |
8115 |
Extraoral radiograph – panoramic |
337.60 |
8116 |
Extraoral radiograph – cephalometric |
337.60 |
8117 |
Diagnostic models |
90.50 |
8118 |
Extraoral radiograph – skull/facial bone |
337.60 |
8119 |
Diagnostic models mounted |
228.00 |
8120 |
Treatment plan completed |
|
8121 |
Oral and/or facial image (digital/conventional) |
90.50 |
8122 |
Microbiological studies |
0.00 |
8123 |
Caries susceptibility tests (By Arrangement) |
0.00 |
8124 |
Pulp tests |
24.90 |
8129 |
Office/hospital visit after regularly scheduled hours |
314.10 |
8131 |
Emergency dental treatment |
128.00 |
8132 |
Pulp removal (pulpectomy) |
241.20 |
8133 |
Recement inlay, onlay, crown or veneer |
128.00 |
8135 |
Remove inlay, onlay or crown |
255.00 |
8136 |
Access through a prosthetic crown or inlay to facilitate root canal treatment |
114.20 |
8137 |
Emergency crown (chair-side) |
439.30 |
8138 |
Remove retention post (prefabricated or cast) |
167.30 |
8139 |
Appointment not kept /30min |
0.00 |
8140 |
House/extended care facility/hospital call |
208.00 |
8141 |
Inhalation sedation – first 15 minutes or part thereof |
93.80 |
8143 |
Inhalation sedation – each addnl 15 minutes |
48.60 |
8144 |
Intravenous sedation |
56.20 |
8145 |
Local anaesthetic – per visit |
87.70 |
8146 |
Resin bonding for restorations |
0.00 |
8147 |
Monitoring equipment for intravenous sedation |
200.00 |
8148 |
Use of dental operating microscope |
|
8149 |
Nutritional counselling |
0.00 |
8150 |
Tobacco counselling |
0.00 |
8151 |
Oral hygiene instruction |
128.00 |
8153 |
Oral hygiene instruction – each additional visit |
93.80 |
8155 |
Polishing – complete dentition |
128.00 |
8157 |
Re-burnishing and polishing of restorations – complete dentition |
128.00 |
8158 |
Enamel microabrasion |
117.30 |
8159 |
Prophylaxis – complete dentition |
251.80 |
8160 |
Removal of gross calculus |
0.00 |
8161 |
Topical application of fluoride – child |
128.00 |
8162 |
Topical application of fluoride – adult |
128.00 |
8163 |
Dental sealant |
84.60 |
8165 |
Sedative filling |
128.00 |
8166 |
Application of desensitising resin, per tooth |
84.60 |
8167 |
Application of desensitising medicament, per visit |
98.50 |
8168 |
Behavior management |
0.00 |
8169 |
Occlusal guard |
492.20 |
8171 |
Mouth guard |
0.00 |
8172 |
Cost of orthotic appliance |
|
8173 |
Space maintainer – fixed, per abutment |
237.80 |
8175 |
Space maintainer – removable |
306.50 |
8176 |
Periodontal screening |
175.50 |
8177 |
Oral hygiene instruction (periodontally compromised patient) |
193.60 |
8178 |
Oral hygiene instruction – each additional visit (periodontally compromised patient) |
104.70 |
8179 |
Polishing – complete dentition (periodontally compromised patient) |
146.70 |
8180 |
Prophylaxis – complete dentition (periodontally compromised patient) |
273.50 |
8183 |
Therapeutic drug injection |
56.20 |
8189 |
Re-examination – existing condition |
100.90 |
8190 |
Consultation – second opinion or advice |
208.80 |
8192 |
Suture – minor |
631.80 |
8197 |
CBCT capture and interpretation with limited field of view of both dental arches without orbits and/or cranium |
|
8198 |
CBCT capture and interpretation for TMJ series including two or more exposures. |
|
8201 |
Extraction – tooth or exposed tooth roots (first per quadrant) |
147.30 |
8202 |
Extraction – each additional tooth or exposed tooth roots |
59.70 |
8203 |
Interpretation of diagnostic image by a practitioner not associated with capture of the image, including the report |
|
8205 |
CBCT image capture with limited field of view – less than one whole jaw |
|
8206 |
CBCT image capture with limited field of view of one full dental arch -mandible |
|
8207 |
CBCT image capture with limited field of view of one full dental arch – maxilla without orbits and/or cranium |
|
8208 |
CBCT capture with limited field of view of both dental arches – without orbits and/or cranium |
|
8209 |
CBCT capture for TMJ series including two or more exposures. |
|
8213 |
Surgical removal of residual roots, first tooth – per tooth |
553.70 |
8214 |
Surgical removal of residual roots, second and subsequent teeth’s roots |
426.90 |
8220 |
Cost of suture material |
|
8231 |
Complete dentures – maxillary and mandibular |
2066.70 |
8232 |
Complete denture – maxillary or mandibular |
1274.20 |
8233 |
Partial denture – resin base – one tooth |
592.40 |
8234 |
Partial denture – resin base – two teeth |
592.40 |