MSP Billing Codes

Specialty: Pediatric Dental Specialists

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Code Description Fee

Antral Surgery

28217 Closure of an oral antral fistula $201.95
28215 Immediate recovery of a tooth or foreign body $92.52
28216 Secondary recovery of a tooth or foreign body $292.19

Consultations / Visits

28012 Call out when dentist called by ha $250.04
28013 Call-out charges - evening $59.42
28014 Call-out charges - night $83.43
28015 Call-out charges - sat/sun or statutory holidays $59.42
28025 Cont care operative surcharges - sat/sun or stats $409.76
28023 Continuing care operative surcharges - evening $409.76
28024 Continuing care operative surcharges - night $575.41

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28001 Emergency consult surcharge-sat,sun,stat 1800-0800 $23.63
28000 Emergency consultation in a hospital $104.53
28008 Hospital visit for medical mgmt of oral disease $21.44
28006 In hospital consult-non emergent $143.37
28005 Non-emergent consultation $104.53

Dental Implants

28169 Intraosseous implants - each additional exposed $49.59
28166 Intraosseous implants - each additional placed $121.76
28168 Intraosseous implants - exposure of first unit $99.15
28165 Intraosseous implants - placement of first unit $194.79
28174 Removal of implants - intraosseous, first unit $97.40
28175 Removal of implants - intraosseous/additional unit $48.69
28172 Removal of implants - subperiosteal/mandibular $584.36

Dentoalveolar Complications

28270 Post operative complications $43.83

Dentoalveolar Surgery

28031 Erupted teeth - each addition tooth $49.69
28030 Erupted teeth - first tooth per quadrant $75.42
28033 Erupted teeth - surgical removal with flap $147.44
28034 Erupted teeth-each add. surgical removal with flap $104.50
28041 Impacted - teeth - each additional 'soft tissue' $97.29
28051 Impacted teeth - each additional 'full bony' $119.02
28046 Impacted teeth - each additional 'part bony' $80.35
28059 Impacted teeth - each additional tooth follicle $112.28
28050 Impacted teeth - full bony $237.48
28054 Impacted teeth - full bony of extreme difficulty $253.25
28045 Impacted teeth - partial bony $169.92
28058 Impacted teeth - removal of a tooth follicle $140.44
28040 Impacted teeth - soft tissue $147.44
28055 Impacted teeth -each add full bony extreme difficu $175.31
28063 Residual roots - bone coverage first per quadrant $170.00
28064 Residual roots - each additional 'bone coverage' $63.51
28061 Residual roots - each additional soft tissue $39.96
28060 Residual roots - soft tissue first per quadrant $90.30

Exposure and Repositioning of Teeth

28074 Surgical uprighting - each additional per quadrant $103.43
28077 Surgical uprighting/repos/uncover-each additional $124.22
28073 Surgical uprighting/repositioning $206.63
28076 Surgical uprighting/repositioning/uncovering $248.45
28070 Tooth transplantation $292.19
28071 Tooth transplantation - each additional $146.08

Lesions

28250 Intraosseous lesions - < or = 1 cm in diameter $220.39
28252 Intraosseous lesions - 1 cm to 5 cm $434.30
28265 Intraosseous lesions - additional lesion 2nd jaw $325.73
28260 Intraosseous lesions - additional lesion same jaw $217.15
28221 Primary closure - additional lision < or = 1 cm $110.20
28226 Primary closure - each additional lesion > 1 cm $217.14
28220 Primary closure - lesion base < or = 1 cm $220.39
28225 Primary closure - lesion base > 1 cm $434.30
28240 Surface oseous lesions - lesion base < or = 1 cm $176.28
28241 Surface osseous lesions - additional < or = 1 cm $88.15
28246 Surface osseous lesions - additional lesion > 1 cm $166.73
28245 Surface osseous lesions - lesion base > 1 cm $333.51

Management of Inflammatory Processes

28365 Extraoral superficial $122.53
28355 Intraoral superficial $82.80
28375 Sequestrectomy for osteomyelitis $249.87
28350 Vestibular or subperiosteal abscess $53.47

Osseous Recontouring

28102 Alveoloplasty - conjunction with multiple extracts $74.03
28100 Alveoloplasty - per edentulous $98.45
28105 Alveoloplasty - tuberosity reduction bone removal $204.52
28107 Removal of a torus/exostosis - per quadrant $160.93
28108 Removal of torus/exostosis - palatal torus $253.81

Removal Foreign Bodies

28214 Removal of foreign body from bone $292.19
28213 Removal of foreign body from soft tissue $92.89

Salivary Glands

28218 Dilation of salivary duct $39.32
28219 Sialodochoplasty $121.76
28247 Submandibular $121.76

Soft Tissue Recontouring

28128 Frenectomy $203.86
28129 Frenectomy - second at same surgery $101.95
28124 Gingivoplasty - per sextant $97.78
28122 Operculectomy $42.21
28120 Uncomplicated excision of hyperplastic tissue $90.30
28131 Vestibuloplasty - each sextant $373.58
28132 Vestibuloplasty - mucous membrane graft $73.03

Surgical Assistant

28301 After three hours continuous surgical assistance $24.35
28300 G.p. surgical assistant $486.97

Surgical Endodontics

28089 Abscess (acute) drainage in hospital-last resort $80.03
28082 Apicoectomy - bicuspids and buccal roots $340.89
28088 Apicoectomy - hemisection $121.38
28084 Apicoectomy - palatal roots of maxillary molars $325.80
28086 Apicoectomy - per root end fill, add $32.52
28090 Root amputations - one root per tooth $242.77
28092 Root amputations - two roots per tooth $291.30

Surgical Excision

28182 Incisional biopsies - hard tissue $194.79
28180 Incisional biopsies - soft tissue $108.44

TMJ

28212 Manipulation under anaesthesia $121.76
28211 Reduction of dislocation $121.76

Treatment of Traumatic Injuries

28201 Additional teeth for management of non-avulsed $32.92
28204 Additional teeth for mangement of fractured tooth $60.35
28209 Closed reduction of mandible with arch bars $489.62
28208 Closed reduction of maxilla with arch bars $431.84
28205 Implantation and splinting of an avulsed tooth $312.12
28203 Management of a fractured tooth $114.96
28200 Management of a non-avulsed tooth with wire $65.83
28206 Reduction of alveolar fracture $485.87
28202 Removal of splint after stabilization $50.44
28210 Simple fracture of mandible $634.95
28207 Single layer suture of lacaration $118.67

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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