Survey average fee charged by the dentists

Below is a survey of average fee charged by the dentists (general practitioners and specialists).  The data gathered from a nationwide random sample of dentists completed in 2013 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 Average fee
D0120 Periodic oral evaluation - established patient $ 46
D0140 Limited oral evaluation - problem focused $ 64
D0145 Oral evaluation/Counseling with primary caregiver for a patient under three yrs old $ 53
D0150 Comprehensive oral evaluation $ 73
D0160 Detailed-extensive oral evaluation, problem focused by report $ 104
D0170 Re-evaluation - limited, problem focused (established patient; not post-operative visit) $ 51
D0180 Comprehensive periodontal evaluation new or established patient
D0190 Screening of a patient $ 48
D0191 Assessment of a patient $ 50
X-Rays Radiographs/diagnostic imaging
D0210 Intraoral - complete series (including bitewings) $ 124
D0220 Intraoral - periapical - first film $ 27
D0230 Intraoral - periapical - each additional film $ 21
D0272 Bitewings - two films $ 42
D0273 Bitewings - three films $ 51
D0274 Bitewings - four films $ 60
D0277 Vertical bitewings -7 to 8 films $ 93
D0330 Panoramic film $ 105
D0350 Oral/facial photographic images $ 43
D0363 Cone beam-3D image reconstruction using existing data includes multiple images $ 331
Tests/Examinations
D0417 Collection/preparation of saliva sample for Lab diagnosis testing $ 98
D0418 Analysis of saliva sample $ 114
D0431 Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities $ 56
D0470 Diagnostic casts $ 94
Preventive
D1110 Prophylaxis - adult $ 85
D1120 Prophylaxis - child $ 63
D1206 Topical fluoride varnish $ 36
D1208 Topical application of fluoride
D1320 Tobacco counseling for the control/prevention  of oral disease $ 31
D1330 Oral hygiene instructions $ 24
D1351 Sealant - per tooth $ 49
D1352 Preventive resin restoration in a moderate to high caries risk patients – permanent tooth $ 88
D1510 Space maintainer - fixed - unilateral $ 290
D1515 Space maintainer - fixed - bilateral $ 388
Restorative –Amalgam
D2140 Amalgam - one surface, primary or permanent $ 125
D2150 Amalgam - two surfaces, primary or permanent $ 155
D2160 Amalgam - three surfaces, primary or permanent $ 186
D2161 Amalgam- four or more surfaces, primary or permanent $ 221
Restorative – Composite ( Direct)
D2330 Composite - one surface, anterior $ 149
D2331 Composite - two surfaces, anterior $ 182
D2332 Composite - three surfaces, anterior $ 219
D2335 Composite – four or more surfaces, or involving incisal angle, anterior $ 267
D2390 Composite crown, anterior $ 363
D2391 Composite - one surface, posterior $ 163
D2392 Composite – two surfaces, posterior $ 209
D2393 Composite – three surfaces, posterior $ 253
D2394 Composite – four or more surfaces, posterior $ 298
Restorative – Inlay/Onlay
D2520 Inlay - metallic - two surfaces $ 803
D2543 Onlay - metallic - three surfaces $ 934
D2620 Inlay - porcelain/ceramic - two surfaces $ 874
D2642 Onlay - porcelain/ceramic - two surfaces $ 938
D2643 Onlay - porcelain/ceramic - three surfaces $ 984
D2644 Onlay - porcelain/ceramic – four or more surfaces $ 1,017
D2651 Inlay - resin-based composite - two surfaces $ 775
D2662 Onlay - resin-based composite - two surfaces $ 824
D2663 Onlay - resin-based composite - three surfaces $ 858
D2664 Onlay - resin-based composite –four or more surfaces $ 898
Crowns and related restoration
D2710 Crown, resin-based composite (indirect) $ 686
D2740 Crown - porcelain/ceramic substrate $ 1,070
D2750 Crown - porcelain fused to high noble metal $ 1,050
D2751 Crown - porcelain fused to predominantly base metal $ 962
D2752 Crown - porcelain fused to noble metal $ 1,003
D2780 Crown - 3/4 cast high noble metal $ 1,033
D2783 Crown - 3/4 porcelain/ceramic $ 1,042
D2790 Crown - full cast high noble
metal
$ 1,069
D2799 Provisional crown (temporary crown) $ 313
D2920 Recement crown $ 96
D2930 Prefabricated stainless crown – primary tooth $ 249
D2931 Prefabricated stainless crown – permanent tooth $ 292
D2940 Protective restoration $ 104
D2950 Core buildup, including any pins $ 243
D2952 Postand core in addition to crown; indirect fabricated $ 358
D2954 Prefabricated post and core in addition to crown $ 300
D2961 Labial veneer (resin laminate) - laboratory $ 825
D2962 Labial veneer (porcelain laminate) - laboratory $ 1,050
D2970 Temporary crown (fractured tooth) $ 269
D2981 Inlay repair necessitated by restorative material failure $ 219
D2982 Onlay repair necessitated by restorative material failure $ 224
D2983 Veneer repair necessitated by restorative material failure $ 223
D2990 Resin infiltration of incipient smooth surface lesions $ 143
Endodontics (including treatment plan and follow-up), excluding final restoration
D3110 Pulp cap - direct $ 73
D3120 Pulp cap - indirect $ 71
D3220 Therapeutic pulpotomy  - removal of pulp coronal to the dentinocemental junction and application of medicament $ 169
D3221 Pulpal debridement, primary and permanent teeth $ 175
D3222 Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development

$ 205
Endodontic therapy on primary tooth excluding final restoration
D3230 Pulp therapy (resorbable filling)-anterior primary tooth $ 215
D3240 Pulp therapy (resorbable filling)- posterior primary tooth $ 237
Endodontic therapy and related  on permanent tooth excluding final restoration
D3310 Endodontic therapy, permanent anterior tooth $ 683
D3320 Endodontic therapy, bicuspid tooth $ 795
D3330 Endodontic therapy, molar $ 965
D3331 Treatment of root canal obstruction (nonsurgical access) $ 401
D3332 Incomplete endodontic therapy; inoperable, unrestorable or fractured tooth $ 304
D3346 Re-treatment of previous root canal therapy,  anterior tooth $ 774
D3347 Re-treatment of previous root canal therapy,  bicuspid tooth $ 888
D3348 Re-treatment of previous root canal therapy,  molar tooth $ 1,054
D3351 Apexification/recalcification/pulp regeneration –first visit (apical closure, calcific repair of perforations, root resorption) $ 285
D3352 Apexification/recalcification/pulp regeneration – interim medication replacement $ 196
D3353 Apexification/recalcification/pulp regeneration - final visit $ 414
D3354 Pulp regeneration - completion of regenerative treatment in an immature permanent tooth with a necrotic pulp $ 251
D3410 Apicoectomy/periradicular surgery - anterior $ 614
D3421 Apicoectomy/periradicular surgery – bicuspid (first root) $ 669
D3425 Apicoectomy/periradicular surgery – molar (first root) $ 738
Periodontics (includes post operative care)
D4210 Gingivectomy or gingingivoplasty – four or more contiguous teeth or tooth bounded spaces per quadrant $ 515
D4211 Gingivectomy or gingingivoplasty – one to three contiguous teeth or tooth bounded spaces per quadrant $ 251
D4212 Gingivectomy or gingivoplasty to allow access for restorative procedure, per tooth $ 204
D4240 Gingival flap procedure, including root planning – four or more contiguous teeth or tooth bounded spaces per quadrant $ 607
D4241 Gingival flap procedure, including root planning –one to  three contiguous teeth or tooth bounded spaces per quadrant $ 466
D4249 Clinical crown lengthening - hard tissue $ 638
D4260 Osseous surgery (including flap entry and closure) – four or more contiguous teeth or tooth bounded spaces per quadrant $ 937
D4261 Osseous surgery(including flap entry and closure) – one to three contiguous teeth or tooth bounded spaces per quadrant $ 669
D4263 Bone replacement graft - first site in quadrant $ 498
D4264 Bone replacement graft - each additional site in quadrant $ 365
D4266 Guided tissue regeneration - resorbable barrier, per site $ 531
D4267 Guided tissue regeneration - resorbable barrier, per site including membrane removal
D4273 Subepithelial connective tissue graft procedures, per tooth
D4275 Soft tissue allograft $ 855
D4277 Free soft tissue graft procedure (including donor site surgery), first tooth or edentulous tooth position in graft $ 748
D4321 Provisional splinting – extra-coronal $ 354
D4341 Periodontal scaling and root planning – four or more teeth per quadrant $ 232
D4342 Periodontal scaling and root planning – one to three teeth per quadrant $ 162
D4355 Full mouth debridement to enable comprehensive evaluation and diagnosis $ 148
D4381 Localized delivery of antimicrobial agents via a controlled release vehicle into diseased crevicular tissue, per tooth $ 81
D4910 Periodontal maintenance $ 128
Prosthodontics – Removable
Complete dentures include post-operative care
D5110 Complete denture – maxillary $ 1,469
D5120 Complete denture – mandibular $ 1.473
D5130 Immediate denture – maxillary $ 1,559
D5140 Immediate denture – mandibular $ 1,561
Partial dentures include post-operative care
D5211 Maxillary partial denture – resin base (including clasps, rests, and teeth) $ 1,111
D5212 Mandibular partial denture – resin base (including clasps, rests, and teeth) $ 1,120
D5213 Maxillary partial denture – cast metal framework with resin denture bases (including clasps, rests, and teeth) $ 1,547
D5214 Mandibular partial denture – cast metal framework with resin denture bases (including clasps, rests, and teeth) 1,553
D5225 Maxillary partial denture – flexible base (including clasps, rests, and teeth) $ 1,340
D5226 Mandibular partial denture – flexible base (including clasps, rests, and teeth) $ 1,342
Repair -  complete dentures
D5510 Repair broken complete denture base $ 188
D5520 Replace broken or missing tooth in complete denture (per tooth) $ 163
D5710 Rebase complete maxillary denture $ 499
D5730 Reline complete maxillary denture (chair side) $ 303
D5731 Reline complete mandibular denture (chair side) $ 300
D5750 Reline complete maxillary denture (laboratory) $ 407
D5751 Reline complete mandibular denture (laboratory) $ 408
Repair – partial dentures
D5610 Repair resin denture base $ 181
D5640 Replace broken teeth - per tooth $ 162
D5650 Add tooth to existing partial denture $ 195
D5660 Add clasp to existing partial denture $ 232
D5710 Replace maxillary complete denture $ 499
D5730 Reline complete maxillary denture (chairside)

$ 303
D5731 Reline complete mandibular denture (chairside) $ 300
D5750 Reline complete maxillary denture (laboratory) $ 407
D5751 Reline complete mandibular denture (laboratory) $ 408
Implants
D6010 Surgical placement of implant body: endosteal implant $ 1,788
D6012 Surgical placement of interim implant body for transitional prosthesis: endosteal implant $ 1,466
D6051 Interim abutment

$ 476
D6053 Implant/abutment supported removable denture for completely edentulous arch $ 2,235
D6055 Connecting bar – implant supported or abutment supported $ 2,015
D6056 Prefabricated abutment – includes modification and placement $ 630
D6057 Custom abutment - includes  placement $ 777
D6059 Abutment supported porcelain fused to metal crown (high noble metal) $ 1,292
D6066 Implant supported porcelain fused to metal crown (titanium, titanium alloy, high noble metal) $ 1,356
D6069 Abutment supported retainer for porcelain to metal FPD (high noble metal) $ 1,297
D6076 Implant supported retainer for porcelain fused to metal FPD (titanium, titanium alloy, high noble metal) $ 1,358
D6080 Implant maintenance procedures, including removal of prosthesis, cleansing of prosthesis and abutments and reinsertion of prosthesis $ 171
D6104 Bone graft at a time of implant placement $ 461
Prosthodontics (fixed)
Fixed partial denture pontics
D6205 Pontic - indirect resin-based composite $ 858
D6210 Pontic - cast high noble metal $ 1,033
D6240 Pontic - porcelain fused to high noble metal $ 1,030
D6241 Pontic - porcelain fused to predominantly base metal $ 956
D6245 Pontic - porcelain/ceramic $ 1,053
D6253 Final impression $ 451
Fixed partial denture retainers – inlays/onlays
D6545 Retainer – cast metal for resin bonded fix prosthesis $ 627
Fixed partial denture retainers – crowns
D6710 Crown - indirect resin-based composite $ 875
D6750 Crown - porcelain fused to high noble metal $ 1,050
D6751 Crown - porcelain fused to predominantly base metal $ 958
D6790 Crown - full cast high noble metal $ 1,046
D6793 Provisional retainer crown $ 429
D6930 Recement fixed partial denture $ 142
Oral  and maxillofacial surgery
Extraction (includes post-operative care, suture, and anesthesia)
D7111 Extraction, coronal remnants - deciduous tooth $ 112

D7140 Extractionerupted tooth or exposed root (elevation and forceps removal) $ 156


D7210 Surgical removal of erupted tooth requiring removal of bone and section of tooth, and including elevation of mucoperiosteal flap $ 253




D7220 Removal of impacted tooth - soft tissue $ 290

D7230 Removal of impacted tooth - partially bony $ 363
D7240 Removal of impacted tooth - completely bony $ 433
D7250 Surgical removal of residual tooth roots (cutting procedure) $ 265
D7251 Coronectomy - intentional partial tooth removal $ 329
Other surgical procedure
D7286 Biopsy of oral tissue – soft $ 265
D7287 Exfoliative cytological sample collection $ 163
D7288 Brush biopsy - transepithelial sample collection $ 161
Alveoloplasty – surgical preparation of ridge
D7310 Alveoloplasty in conjunction with extractions – four or more teeth or tooth spaces, per quadrant $ 257
D7320 Alveoloplasty not in conjunction with extractions – four or more teeth or tooth spaces, per quadrant $ 346
Surgical excision of soft tissue  lesions
D7410 Excision of benign lesion up to 1.25 cm $ 313
Surgical excision of intra-osseous  lesions
D7440 Excision of malignant tumor – lesion up to 1.25 cm $ 457
D7450 Removal of benign odontogenic cyst or tumor-lesion up to 1.25 cm $ 391
Reduction of dislocation and management of other temporomandibular joint dysfunctions
D7880 Occlusal orthotic device, by report $ 681
Repair of traumatic wounds
D7910 Suture of recent small wounds up to 5 cm $ 221
Other repair procedures
D7953 Bone replacement graft for ridge preservation – per site $ 423
D7960 Frenulectomy (Frenectomy or frenotomy) – separate procedure not incidental to another $ 368
D7970 Excision of hyperplastic tissue – per arch $ 371
Orthodontics
Limited orthodontic treatment
D8020 Limited treatment of the transitional dentition $ 1,938
D8030 Limited treatment of the adolescent dentition  $ 2,361
D8040 Limited treatment of the adult dentition  $ 2,712
Interceptive orthodontic treatment
D8050 Interceptive treatment of the primary dentition $ 2,108
D8060 Interceptive treatment of the transitional dentition $ 2,110
Comprehensive orthodontic treatment
D8070 Comprehensive treatment of the transition dentition $ 4,766
D8080 Comprehensive treatment of the adolescent dentition $ 4,938
D8090 Comprehensive treatment of the adult dentition $ 5,130
Other orthodontic services
D8670 Periodic treatment visit (as part of contract) $ 242
D8690 Orthodontic treatment ( alternative billing to a contract fee $ 273
D8692 Replacement of lost or broken retainer $ 255
Adjunctive General Services
D9110 Palliative (emergency) treatment of dental pain – minor procedure $ 111
D9120 Fixed partial denture sectioning $ 145
Anesthesia
D9215 Local anesthesia $ 30
D9230 Analgesia, anxiolysis, inhalation of nitrous oxide $ 53
D9241 Intravenous conscious sedation/analgesia – first 30 minutes $ 333
D9242 Intravenous conscious sedation/analgesia – each additional 15 minutes $ 68
D9248 Non-intravenous conscious sedation $ 177
Professional consultation
D9310 Consultation (diagnostic service provided by dentist or physician other than requesting dentist or physician) $ 84
Professional visits
D9410 House/extended care facility call $ 173
D9420 Hospital or ambulatory surgical center call $ 210
D9430 Office visit for observation (during regular hours) – no other service performed $ 57
D9440 Office visit – after regular hours $ 139
D9450 Case presentation, detailed and extensive treatment planning $ 129
Drugs
D9610 The parenteral therapeutic  drug, single administration $ 53
D9630 Other drugs or medicaments, by report $ 27
Miscellaneous services
D9910 Application of desensitizing medicament $ 48
D9911 Application of desensitizing resin for cervical and root surface per tooth $ 53
D9920 Behavior management, by report $ 95
D9930 Treatment of complications (post–surgical) – unusual circumstances, by report $ 102
D9940 Occlusal guard, by report $ 477
D9941 Fabrication of athletic  mouthguard $ 197
D9951 Occlusal adjustment – limited $ 132
D9952 Occlusal adjustment – complete $ 486
D9972 External bleaching - per arch perform in office $ 276
D9974 Internal bleaching - per tooth $ 227
D9975 External bleaching for home application, per arch; includes materials and fabrication of custom trays $ 237