MSP Billing Codes

Specialty: Orthodontic Specialists

Code Description Fee
3964 Newborn-initial examination & expl. re: nature of $95.05
3965 Ortho care of newborn < 2yrs. bone-moving $1,325.02
39966 Orthodontic care of newborn - unilateral $3,809.01
39967 Orthodontic care of newborn - bilateral $4,847.85
39968 Orthodontic care of newborn - bilateral $1,500.00
3955 Deciduous - simple - malocclusion req. the use of $2,902.34
3956 Deciduous - complex-malocclusion req. 2 or more $2,902.34
3957 Severe - malocclusion req. 2 or more removable $2,902.34
3978 Full alignment & retention.- initial exam. $95.05
3979 Full alignment and retention - diagnostic phase - $304.18

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3980 Full alignment and retention - case analysis and $221.78
3970 Initial exam.-will include clinical exam.and exp. $95.05
3971 Diagnostic phase-diagnostic models,facials, $304.18
3972 Case analysis & conslt.includes treatment planning $221.78
3958 Mixed dentition - simple - malocclusion req.use of $2,902.34
3959 Mixed dentition - complex- malocclusion req. 2 or $2,902.34
3960 Mixed dentition - severe-malocclusion req. 2 or $2,902.34
3966 Observation & adjustments -(observation to be $38.03
3967 Observation & adjustments - serial extraction $57.34
3968 Observation & adjustments - removable appliance $43.10
3969 Observation & adjustments - fixed appliance - to $39.98
3952 Severe congenital cranio-facial anomalies-initial $95.05
3953 Severe congenital cranio-facial /diagnostic phase $304.18
3954 Severe congenital cranial-facial anomalies - case $221.78
3961 Permanent dentition - simple - malocclusion req a $2,902.34
3962 Permanent dentition - complex-malocclusion $2,902.34
3963 Permanent dentition-severe-malocclusion req. a $2,902.34
39976 Palatal fistula obturator $1,152.68
39977 Continuing care of palatal fistula obturator $48.75
39978 Remake of a palatal fistula obturator $764.42
39979 Speech obturator $7,598.06
39980 Simple continuing care of speech obturator $97.47
39981 Complex continuing care of speech obturator $487.44
39982 Speech obturator remake $5,063.27
39983 Speech lift $5,760.33
39984 Continuing care of speech lift $73.12
39985 Speech lift remake $3,840.22
3973 Simple - malocclusions req. uncomplicated $2,758.48
3974 Complex - malocclusions req. one complexed fixed $1,032.93
3975 Severe - malocclusions that req. one or more $1,267.41
3981 Class 1 malocclusions-simple - requiring banding $1,774.37
3982 Class 1 malocclusions-complex-full banding of both $1,869.42
3983 Class 1 malocclusions - severe- requiring full $1,964.46
3984 Class 11 malocclusions-simple requiring banding in $1,964.46
3985 Class 11 malocclusions - complex-requiring full $2,059.52
3986 Class 11 malocclusions-severe - full banding of $2,154.56
3987 Class 111 malocclusions - simple - banding in both $1,964.46
3988 Class 111 malocclusions - complex - full banding $2,059.52
3989 Class 111 malocclusions - severe - requiring full $2,154.56

The information presented on this page is general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBCx or its affiliates.

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