FILLINGS CODES ANTERIOR TEETH

Comprehensive oral Comprehensive oral 70

011 examination examination
Pulp testing per Pulp testing per 15
061 appointment appointment
Panoramic radiograph – Panoramic radiograph – 120
037 per exposure per exposure
Intraoral periapical or Intraoral periapical or 30
bitewing radiograph – per bitewing radiograph – per
022 exposure exposure
Adhesive restoration Adhesive restoration 275
three surfaces anterior three surfaces anterior
523 tooth direct tooth direct
Adhesive restoration four Adhesive restoration four 350
surfaces anterior tooth surfaces anterior tooth
524 direct direct
Desensitising procedure – Desensitising procedure – 100
165 per appointment per appointment
411 Direct pulp capping Direct pulp capping 50
Topical application of Topical application of 80
remineralisation and/or remineralisation and/or
cariostatic agents one cariostatic agents one
121 treatment treatment

FILLINGS CODES posterior teeth

Comprehensive oral Comprehensive oral 70

011 examination examination
Pulp testing per Pulp testing per 15
061 appointment appointment
Panoramic radiograph – Panoramic radiograph – 120
037 per exposure per exposure
Intraoral periapical or Intraoral periapical or 30
bitewing radiograph – per bitewing radiograph – per
022 exposure exposure
Adhesive restoration Adhesive restoration 275
three surfaces posterior three surfaces posterior
533 tooth direct tooth direct
534 Adhesive restoration four Adhesive restoration four 350
surfaces posterior tooth surfaces posterior tooth
 direct direct
Desensitising procedure – Desensitising procedure – 100
165 per appointment per appointment
411 Direct pulp capping Direct pulp capping 50

Codes for scaling

111 Removal of plaque and/or stain Removal of plaque and/or stain 80

Removal of calculus – first Removal of calculus – first 125
114 appointment appointment
Treatment of acute periodontal Treatment of acute periodontal 150
213 infection – per appointment infection – per appointment
392 Drainage of abscess Drainage of abscess 100
Panoramic radiograph – per Panoramic radiograph – per 120
037 exposure exposure
011 Comprehensive oral examination Comprehensive oral examination 70

EXTRACTION FOR PEDO

Removal of a tooth or Removal of a tooth or 160

311 part(s) thereof part(s) thereof
Intraoral periapical or Intraoral periapical or 30
bitewing radiograph – per bitewing radiograph – per
022 exposure exposure
911 Palliative care Palliative care 100

EXTRACTION FOR ADULTS

Intraoral periapical or Intraoral periapical or 30

bitewing radiograph – per bitewing radiograph – per
022 exposure exposure
911 Palliative care Palliative care 100
Surgical removal of a Surgical removal of a 950
tooth or tooth fragment tooth or tooth fragment
requiring both removal of requiring both removal of
324 bone and tooth division bone and tooth division
341 Removal of hyperplastic Removal of hyperplastic 650
 tissue tissue

For ROOT CANAL TREATMENT

Intraoral periapical or Intraoral periapical or 30

bitewing radiograph – per bitewing radiograph – per
022 exposure exposure
Panoramic radiograph – Panoramic radiograph – 120
037 per exposure per exposure
Comprehensive oral Comprehensive oral 70
011 examination examination
Extirpation of pulp or Extirpation of pulp or 150
debridement of root debridement of root
canal(s) – emergency or canal(s) – emergency or
419 palliative palliative

911 PALLITIVE CARE PALLITIVE CARE 100

061 PULP TASTING PULP TASTING 15

Complete chemo- Complete chemo- 250

mechanical preparation of mechanical preparation of
415 root canal one canal root canal one canal
Root canal obturation – Root canal obturation – 125
417 one canal one canal
392 Drainage of abscess Drainage of abscess 100
Adhesive restoration Adhesive restoration 240
three surfaces posterior three surfaces posterior
533 tooth direct tooth direct
Provisional Provisional 50
(intermediate/temporary) (intermediate/temporary)
572 restoration – per tooth restoration – per tooth
 Comprehensive oral Comprehensive oral
011 examination examination
Full crown non-metallic
613 indirect 1200.0
Diagnostic model – per
071 model 100.0
231 Gingivectomy – per tooth 200.0
Intraoral periapical or
bitewing radiograph – per
022 exposure 30.0
Panoramic radiograph –
037 per exposure 120.0
Post and core for crown
625 indirect 150.0
Provisional crown – per
631 tooth 100.0
Recementing crown or
651 veneer 50.0
Recementing bridge or
652 splint – per abutment 50.0
655 Removal of crown 50.0
Removal of bridge or
656 splint 120.0