Insurance Codes per Procedure - Dental XP

Fee Schedule FEE 3 Medical Code 21210 Service Code D3450 D3920 D4210 D4211 D4249 D4260 D4261 D4263 D4264 D4265 D4271 D4273 D4275 D4320 D4321 D4342

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Office Service Codes Procedure - Dental XP

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Surgic removl resid tooth root Vestibuloplasty-ridge ext (inc) Removal of lat exostosis(max or mand) Occlusal orthotic device Osseous, misc.graft auto/nonauto Frenectomy- Seperate Procedure Phase 1 Early Ortho Tx Limited ortho treat, adolescent Limited Ortho Treat, Adult Dent Comprehensive Ortho Adolescent Comprehensive Ortho, Adult Dent

  Surgic

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