Email: drq@vipsperio.comP: 469.231.1155 • F: 972.695.4026
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. We may need to discuss these issues together to find what works best for your practice.
| Code | Description | Fee Ranges* |
|---|---|---|
| D6010 | Dental Implant | $2000-2500.00 |
| D7210 | Extraction | $300-500.00 |
| D4263 | Bone | $500-800.00 |
| D4266 | Membrane | $500-800.00 |
| D7951 | Sinus Life (Lateral) | $2500-3000.00 |
| D7952 | Internal Sinus Lift | $700-1000.00 |
| D4260 | Osseous 4+ teeth/quad | $1500-2000.00 |
| D4261 | Osseous 1-3 teeth/quad | $1100-1300.00 |
| D4270 | Pinhole Surgical Technique (per tooth) | $600-800.00 |
| D4273 | Connective Tissue Graft (1) | $1000-1400.00 |
| D4273 | Connective Tissue Graft (2-4) | $2200-2800.00 |
| D4249 | Clinical Crown Lengthening (1) | $1000-1100.00 |
| D4249 | Clinical Crown Lengthening (2-4) | $2200-2700.00 |
| D4210 | Gingivectomy (1-3) | $1000-1400.00 |
| D4212 | Gingivectomy (4+ teeth/quad) | $1800-2300.00 |
| D7961 | Buccal Frenectomy | $500-600.00 |
| D7962 | Lingual Frenectomy | $500-600.00 |
| D4240 | Gingival Flap | $500-800.00 |
| D7286 | Soft Tissue Biopsy | $200-300.00 |
| D4274 | Distal Wedge | $600-700.00 |
| D7291 | Supracrestal Fiberotomy | $500-600.00 |
| D7280 | Surgical/Access/Unerupted | $500-700.00 |
| D7261 | Sinus Closure | $300-500.00 |
| D7310 | Alveoloplasty (per quad) |
$400-500.00 |
| D4275 | Allograft (Alloderm) | $2200-2800.00 |