Laserfiche WebLink
D4270 Pedicle soft tissue graft procedure <br />D4273 Subepithelial connective tissue graft procedures, per tooth <br />D4274 Distal or proximal wedge procedure (when not performed in conjunction with surgical <br />procedures in the same anatomical area) <br />D4275 Soft tissue allograft <br />D4276 Combined connective tissue and double pedicle graft, per tooth <br />D4277 Free soft tissue graft procedure (including donor site surgery), first tooth or <br />edentulous tooth position in graft <br />D4278 Free soft tissue graft procedure (including donor site surgery), each additional <br />contiguous tooth or edentulous tooth position in same graft site <br />Non - surgical periodontal service <br />D4320 Provisional splinting — intracoronal <br />D4321 Provisional splinting — extracoronal <br />D4341 Periodontal scaling and root planing — four or more teeth per quadrant <br />D4342 Periodontal scaling and root planing, — one to three teeth, per quadrant <br />D4355 Full mouth debridement to enable comprehensive evaluation and diagnosis <br />D4381 Localized delivery of antimicrobial agents via controlled release vehicle into diseased <br />crevicular tissue, per tooth <br />Other periodontal services <br />D4910 Periodontal maintenance <br />D4920 Unscheduled dressing change (by someone other than treating dentist or their staff) <br />D4999 Unspecified periodontal procedure, by report <br />D5000 - D5899 PROSTHODONTICS (REMOVABLE) <br />Complete dentures (including routine post - delivery care) <br />D5110 Complete denture — maxillary <br />D5120 Complete denture — mandibular <br />D5130 Immediate denture — maxillary <br />D5140 Immediate denture — mandibular <br />Partial dentures (including routine post - delivery care) <br />D5211 Maxillary partial denture — resin base (including any conventional clasps, rests and <br />teeth) <br />D5212 Mandibular partial denture — resin base (including any conventional clasps, rests and <br />teeth) <br />D5213 Maxillary partial denture — cast metal framework with resin denture bases (including <br />any conventional clasps, rests and teeth) <br />D5214 Mandibular partial denture — cast metal framework with resin denture bases <br />(including any conventional clasps, rests and teeth) <br />D5225 Maxillary partial denture — flexible base (including any clasps, rests and teeth) <br />D5226 Mandibular partial denture — flexible base (including any clasps, rests and teeth) <br />D5281 Removable unilateral partial denture — one piece cast metal (including clasps and <br />teeth) <br />Adjustments to dentures <br />D5410 Adjust complete denture — maxillary <br />D5411 Adjust complete denture — mandibular <br />D5421 Adjust partial denture — maxillary <br />D5422 Adjust partial denture — mandibular <br />Repairs to complete dentures <br />D5510 Repair broken complete denture base <br />D5520 Replace missing or broken teeth — complete denture (each tooth) <br />CDT2015 (Eff. 01- 01 -15) <br />