Dental fees survey completed in 2016

Below is a survey of average fee charged by the dentists (general practitioners and specialists in U.S).  The data gathered from a nationwide random sample of dentists completed in 2016 by American Dental Association (ADA).

The survey data provides here acts as a guide to the dental fees only. Therefore, the cost appears in this data may not interpret as a fee schedule in any way.  Individual dentist establishes his/her fees based on his/her expenses, including the cost of operating business in a particular location, the cost of materials, and living expenses, etc.

 
Diagnostic


Procedure code
Service Description
Fees in U.S $
D0120
Periodic oral evaluation
49
D0140
Limited oral evaluation - problem focused
68
D0145
Oral evaluation/Counseling with care giver < 3 yrs old
59
D0150
Comprehensive  oral evaluation
79
D0160
Detailed-extensive oral evaluation, problem focus
111
D0170
D0171
Re-evaluation - limited, problem focused
Re-evaluation post –operative office visit
58
19
D0180
D0190
D0191
Comprehensive periodontal evaluation
Screening of a patient
Assessment of a patient
91
61
59



X-Rays /diagnostic imaging


D0210
Intraoral - complete series of images
133
D0220
Intraoral - periapical - first image
28
D0230
D0251
Intraoral - periapical - each additional image
Extra-oral posterior dental image
22
29
D0272
Bitewings – two images
45
D0273
Bitewings – three images
54
D0274
Bitewings - four images
63
D0277
Vertical bitewings - 7 to 8 images
96
D0330
Panoramic image
112
D0350
D03364

D0365
D0366
D0367
Oral/facial photographic images
Cone beam CT capture and interpretation of image less than whole jaw
Cone beam CT  and interpretation – full lower jaw
Cone beam CT  and interpretation – full upper jaw
Cone beam CT  and interpretation – full both jaws
50
279

311
308
339



Tests/Examinations


D0417
D0418
Collection/preparation of saliva sample for diagnosis
Analysis of saliva sample
142
137
D0431
Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities
61
D0470
D0601

D0602

D0603
Diagnostic casts
Caries risk assessment and documentation with a finding of low risk
Caries risk assessment and documentation with a finding of moderate risk
Caries risk assessment and documentation with a finding of high risk
102
39

39

39



Preventive


D1110
Prophylaxis - adult
91
D1120
Prophylaxis - child
67
D1206
D1208
Topical application of fluoride varnish
Topical application of fluoride excluding varnish
39
36
D1320
Tobacco counseling for the control/prevention  of oral disease
37
D1330
Oral hygiene instructions
27
D1351
Sealant - per tooth
52
D1352

D1354
Preventive resin restoration in a moderate to high caries risk patients – permanent tooth
Interim caries arresting medicament application
95

64
D1510
Space maintainer - fixed - unilateral
306
D1515
Space maintainer - fixed - bilateral
409



Restorative –Amalgam


D2140
Amalgam - one surface, primary or permanent
136
D2150
Amalgam - two surfaces, primary or permanent
169
D2160
Amalgam - three surfaces, primary or permanent
201
D2161
Amalgam- four or more surfaces, primary or permanent
238



Restorative – Direct  Composite


D2330
Composite - one surface, anterior
160
D2331
Composite - two surfaces, anterior
194
D2332
Composite - three surfaces, anterior
234
D2335
Composite – four or more surfaces, or involving incisal angle, anterior
287
D2390
Composite crown, anterior
401
D2391
Composite - one surface, posterior
174
D2392
Composite – two surfaces, posterior
223
D2393
Composite – three surfaces, posterior
273
D2394
Composite – four or more surfaces, posterior
320



Restorative – Inlay/Onlay


D2520
Inlay - metallic - two surfaces
871
D2543
Onlay - metallic - three surfaces
1,004
D2620
Inlay - porcelain/ceramic - two surfaces
956
D2642
Onlay - porcelain/ceramic - two surfaces
1,015
D2643
Onlay - porcelain/ceramic - three surfaces
1,055
D2644
Onlay - porcelain/ceramic - four or more surfaces
1,096
D2651
Inlay - resin-based composite - two surfaces
863
D2662
Onlay - resin-based composite - two surfaces
906
D2663
Onlay - resin-based composite - three surfaces
949
D2664
Onlay - resin-based composite-four or more surfaces
987



Crowns and related restoration


D2710
Crown, resin-based composite (indirect)
779
D2740
Crown - porcelain/ceramic substrate
1,135
D2750
Crown - porcelain fused to high noble metal
1,121
D2751
Crown - porcelain fused to predominantly base metal
1,041
D2752
Crown - porcelain fused to noble metal
1,078
D2780
Crown - 3/4 cast high noble metal
1,115
D2783
Crown - 3/4 porcelain/ceramic
1,114
D2790
D2794
Crown - full cast high noble metal
Crown - Titanium
1,151
1,120
D2799
Provisional crown (temporary crown)
343
D2920
D2929
Re-cement or re-bond crown
Pre-fabricated porcelain/ceramic crown - primary tooth
104
315
D2930
Pre-fabricated stainless crown – primary tooth
262
D2931
Pre-fabricated stainless crown – permanent tooth
312
D2940
D2949
Protective restoration
Restorative foundation for an indirect restoration
112
188
D2950
Core buildup, including any pins
260
D2952
Post and core in addition to crown, indirect fabricated
393
D2954
Prefabricated post and core in addition to crown
321
D2961
Labial veneer (resin laminate) - laboratory
929
D2962
Labial veneer (porcelain laminate) - laboratory
1,128
D2980
D2981
D2982
D2983
D2990
Crown repair necessitated by restorative material failure
Inlay repair due to restorative material failure
Onlay repair due to material failure
Veneer repair due to material failure
Resin infiltration of incipient smooth surface lesions
247
240
253
251
130



Pulpal therapy excludes final restoration


D3110
Pulp cap - direct
79
D3120
Pulp cap - indirect
75
D3220
Therapeutic pulpotomy
181
D3221
Pulpal debridement, primary and permanent teeth
192
D3222
Partial pulpotomy for apexogenesis-permanent tooth with incomplete root development
238
D3230
Pulpal therapy (resorbable filling)-anterior primary tooth
233
D3240
Pulpal therapy (resorbable filling)-posterior primary tooth
255



Endodontic therapy (root canal treatment, RCT) and related  on permanent tooth


D3310
Endodontic therapy Anterior permanent tooth
736
D3320
Endodontic therapy Bicuspid
853
D3330
Endodontic therapy Molar
1,033
D3331
Treatment of root canal obstruction; non surgical access
454
D3332
Incomplete endodontic therapy; inoperable, unrestorable or fractured tooth
348
D3346
Re-treatment of previous RCT,  anterior tooth
846
D3347
Re-treatment of previous RCT,  bicuspid tooth
956
D3348
Re-treatment,  molar tooth
1,144
D3351
Apexification/recalcification –first visit
331
D3352
Apexification/recalcification – interim medication replacement visit
220
D3353
D3355
D3356
Apexification/recalcification - final visit
Pulpal regeneration - first visit
Pulpal regeneration – interim medication placement
489
344
250
D3410
Apicoectomy  surgery - anterior
669
D3421
Apicoectomy surgery – bicuspid (first root)
747
D3425
D3426
Apicoectomy surgery – molar (first root)
Apicoectomy each additional root
843
355



Periodontics (includes post operative care)


D4210
Gingivectomy or gingingivoplasty – four or more contiguious teeth or tooth bounded spaces per quadrant
558
D4211


D4212
Gingivectomy or gingingivoplasty – one to three contiguious teeth or tooth bounded spaces per quadrant
Gingivectomy or gingingivoplasty to allow access for restoration, per tooth
273


214
D4240
Gingival flap procedure, including root planning – four or more contiguous teeth or tooth bounded spaces per quadrant
671
D4241
Gingival flap procedure, including root planning –one to  three  contiguous teeth or tooth bounded spaces per quadrant
529
D4249
Clinical crown lengthening - hard tissue
692
D4260
Osseous surgery - four or more contiguous teeth or tooth bounded spaces per quadrant
1,040
D4261

D4263
D4264
D4266
D4267
D4273

D4275

D4277

D4278
Osseous surgery - one to three contiguous teeth or tooth bounded spaces per quadrant
Bone replacement graft – first site in quadrant
Bone replacement graft – each additional site in quadrant
Guided tissue regeneration – resorbable barrier, per site
Guided tissue regeneration – non-resorbable barrier, per site
Autogenous connective tissue graft procedure first tooth, implant or edentulous tooth position
Non-Autogenous connective tissue graft procedure first tooth, implant or edentulous tooth position
Free soft tissue graft,  first tooth, implant or edentulous tooth position in graft
Free soft tissue graft procedure addition contiguous tooth, implant or edentulous tooth position in same graft site
793

559
442
602
732
1,033

967

938

591
D4321
Provisional splinting – extra coronal
384
D4341
Periodontal scaling and root planning – four or more teeth per quadrant
249
D4342
Periodontal scaling and root planning – one to three teeth per quadrant
169
D4355
Full mouth debridement to enable comprehensive evaluation and diagnosis
166
D4381
Localized delivery of antimicrobial agents via a control release vehicle into diseased crevicular tissue, per tooth
81
D4910
Periodontal maintenance
137



Prosthodontics – Removable


Complete dentures, includes post operative care


D5110
Complete denture – maxillary (upper)
1,610
D5120
Complete denture – mandibular  (lower)
1.613
D5130
Immediate denture – upper
1,711
D5140
Immediate denture – lower
1,718



Partial dentures, includes post operative care


D5211
Upper partial denture – resin base including clasps
1,215
D5212
Lower partial denture – resin base including clasps
1,220
D5213
Upper partial denture – cast metal framework with resin denture bases
1,685
D5214

D5221
D5222
D5223

D5224

D5225
Lower partial denture – cast metal framework with resin denture bases
Immediate upper partial denture-resin base including clasps
Immediate lower partial denture-resin base including clasps
Immediate upper partial denture-cast metal framework with resin denture base including clasps
Immediate lower partial denture-cast metal framework with resin denture base including clasps
Upper partial denture – flexible base including clasps
1,688

1,225
1,242
1,549

1,550

1,444
D5226
Lower partial denture – flexible base including clasps
1,444
Repair -  dentures


D5510
Repair broken complete denture base
207
D5520
D5610
D5640
D5650
D5660
Replace broken or missing tooth – complete denture (per tooth)
Repair resin denture base
Replace broken tooth – per tooth
Add tooth to existing partial denture – per tooth
Add clasp to existing partial denture – per tooth
174
199
176
210
250
D5710
D5711
D5720
D5721
Rebase complete upper denture
Rebase complete lower denture
Rebase upper partial denture
Rebase lower partial denture
537
536
513
513
D5730
Reline complete upper denture (chair side)
323
D5731
Reline complete lower denture (chair side)
322
D5750
Reline complete upper denture (laboratory)
431
D5751
Reline complete lower denture (laboratory)
433

Miscellaneous
D5986
D5991
D5994


Fluoride gel carrier
Vesiculobullous disease medicament carrier
Periodontal medicament carrier with peripheral seal – laboratory processed


169
213
429
Implants
D6010
D6011

Surgical placement of implant body: endosteal implant
Second stage implant surgery

1,919
660
D6012

D6051
Surgical placement of interim implant body for transitional prosthesis: endosteal implant
Interim abutment
1,481

430
D6055
Connecting bar – implant supported or abutment supported
2,300
D6056
Prefabricated abutment – includes placement
663
D6057
Custom fabricated abutment - includes placement
816
D6059
Abutment supported porcelain fused to metal crown (high noble metal)
1,352
D6066
Implant supported porcelain fused to metal crown (titanium, titanium alloy, high noble metal)
1,449
D6069
Abutment supported retainer for porcelain to metal FPD (high noble metal)
1,377
D6076
Implant supported retainer for porcelain fused to metal FPD (titanium, titanium alloy, high noble metal)
1,448
D6080


D6100
D6104
Implant maintenance procedures, including removal of prosthesis, cleansing of prosthesis and abutments and reinsertion of prosthesis
Implant removal, by report
Bone graft at time of implant placement
198


599
526



Prosthodontics (fixed)


Fixed partial denture pontics


D6205
Pontic - indirect resin based composite
954
D6210
Pontic - cast high noble metal
1,094
D6240
Pontic - porcelain fused to high noble metal
1,103
D6241
Pontic - porcelain fused to pre-dominantly base metal
1,023
D6245
D6253
Pontic - porcelain/ceramic
Provision pontic – further treatment or completion of diagnosis necessary prior to final impression
1,120
508



Fixed partial denture retainers – crowns

D6545



Retainer – cast metal for resin bonded fix prosthesis



677
D6549
D6710
Resin retainer – for resin bonded fixed prosthesis
Retainer crown - indirect resin based composite
645
985
D6750
Retainer crown - porcelain fused to high noble metal
1,116
D6751
Retainer crown - porcelain fused to predominantly base metal
1,037
D6790
D6793
Retainer crown - full cast high noble metal
Provisional retainer crown – further treatment or completion of diagnosis necessary prior to final impression
1,113
450
D6930
Re-cement  or re-bond fixed partial denture
154



Oral  and maxillofacial surgery


Extraction (includes post operative care, suture, and anesthesia)


D7111
Extraction, coronal remnants - deciduous tooth
120
D7140
Extraction, erupted tooth or exposed root (elevation and/or forceps removal)
169
D7210
Surgical removal of erupted tooth requiring removal of bone and/or section of tooth, and including elevation of mucoperiosteal flap if indicated
271
D7220
Removal of impacted tooth - soft tissue
312
D7230
Removal of impacted tooth - partially bony
386
D7240
Removal of impacted tooth - completely bony
454
D7250
Surgical removal of residual tooth roots (cutting procedure)
287
D7251
Coronectomy - intentional partial tooth removal
408



Other surgical procedure


D7286
Incisional biopsy of oral tissue – soft
298
D7287
Exfoliative cytological sample collection
193
D7288
D7295
Brush biopsy - trans epithelial sample collection
Harvest of bone for use of autogenous grafting procedure
188
632



Alveoloplasty – surgical preparation of ridge


D7310
Alveoloplasty in conjunction with extractions – four or more teeth or tooth spaces, per quadrant
277
D7320
Alveoloplasty not in conjunction with extractions – four or more teeth or tooth spaces, per quadrant
385



Surgical excision of soft tissue  lesions


D7410
Excision of benign lesion up to 1.25 cm
347



Surgical excision of intra-osseous  lesions


D7440
Excision of malignant tumor – lesion up to 1.25 cm
627
D7450
D7640
Removal of benign odontogenic cyst or tumor lesion up to 1.25 cm
Mandible – closed reduction (teeth immobilized, if present)
521
3,472
D7880
Occlusal orthotic device, by report
767



Repair of traumatic wounds


D7910
D7921
Suture of recent small wounds up to 5 cm
Collection and application of autologous blood concentrate product
244
325



Other repair procedures


D7953
Bone replacement graft for ridge preservation – per site
486
D7960
Frenulectomy (Frenectomy or frenotomy) – separate procedure not incidental to another
400
D7970
Excision of hyperplastic tissue – per arch
405



Orthodontics


D8020
Limited treatment of the transitional dentition
2,322
D8030
Limited treatment of the adolescent dentition
2,672
D8040
Limited treatment of the adult dentition
2,929
D8050
Interceptive treatment of the primary dentition
2,378
D8060
Interceptive treatment of the transitional dentition
2,353
D8070
Comprehensive treatment of the transition dentition
5,149
D8080
Comprehensive treatment of the adolescent dentition
5,193
D8090
D8660
Comprehensive treatment of the adult dentition
Pre-orthodontic treatment exam to monitor growth and development
5,278
249
D8670
D8681
Periodic treatment visit (as part of contract)
Removable orthodontic retainer adjustment
237
162
D8690
Orthodontic treatment ( alternative billing to a contract fee)
316
D8692
Replacement of lost or broken retainer
285



General Services


D9110
Palliative (emergency) treatment of dental pain – minor procedure
118
D9120
Fixed partial denture sectioning
164



Anesthesia


D9210

D9215
Local anesthesia not in conjunction with operative or surgical procedures
Local anesthesia in conjunction with operative or surgical procedures
58

35
D9230
D9243
Inhalation of nitrous oxide/analgesia, anxiolysis
Intravenous moderate (conscious) sedation/analgesia each 15 minutes increment
62
190
D9248
Non-intravenous conscious sedation
203



Professional consultation


D9310
Consultation (diagnostic service provided by dentist or physician other than requesting dentist or physician)
98



Professional visits


D9410
House/extended care facility call
181
D9420
Hospital or ambulatory surgical center call
227
D9430
Office visit for observation (during regular hours) – no other service performed
60
D9440
Office visit – after regularly hours
148
D9450
Case presentation, detailed and extensive treatment planning
130


Drugs


D9610
Therapeutic parenteral drug, single administration
64
D9630
Other drugs and/or medicaments, by report
30



Miscellaneous services


D9910
Application of desensitizing medicament
52
D9911
Application of desensitizing resin for cervical and/or root surface per tooth
56
D9920
D9930
D9932
D9933
D9934
D9935
Behavior management, by report
treatment of complication – post surgical
Cleaning/inspection of removable upper full denture
Cleaning/inspection of removable lower full denture
Cleaning/inspection of removable upper partial denture
Cleaning/inspection of removable lower  partial denture
111
107
62
62
64
64
D9940
Occlusal guard, by report
508
D9941
D9943
Fabrication of athletic  mouth guard
Occlusal guard adjustment
221
97
D9951
Occlusal adjustment – limited
141
D9952
Occlusal adjustment – complete
527
D9972
External bleaching - per arch
287
D9974
D9975
Internal bleaching - per tooth
External bleaching  for home application, per arch, includes materials and fabrication of custom trays
248
250