As of 10/28/19
D0160 – Detailed and extensive oral evaluation – problem focused - $350.00
D7880 – Occlusal orthotic device, by report – splints provided for treatment of TMJ - $2995.00 + 2 splint adjustments
D7881 – Occlusal orthotic device adjustment - $295.00
D7899 – Unspecified TMD therapy, by report – used for procedure not adequately described by a code - $295.00 - $2995.00
D8010 – Limited orthodontic treatment of the primary dentition - $600.00
D8020 – Limited orthodontic treatment of the transitional dentition - $1800.00
D8030 – Limited orthodontic treatment of the adolescent dentition - $3800.00
D8040 – Limited orthodontic treatment of the adult dentition - $4300.00
D8060 – Interceptive orthodontic treatment of the transitional dentition – 1800.00 - $2770.00
D8070 – Comprehensive orthodontic treatment of the transitional dentition - $2445.00 - $2945.00
D8080 – Comprehensive orthodontic treatment of the adolescent dentition - $5145.00 – $5895.00
D8090 – Comprehensive orthodontic treatment of the adult dentition - $5745.00 - $6745.00
D8210 – Removable appliance therapy - $180.00 - $700.00
D8220 – Fixed appliance therapy - $600.00 - $1800.00
D8680 – Orthodontic retention (removal of appliances, construction/placement of retainer) - $750.00 - $2000.00
D8681 – Removable orthodontic retainer adjustment - $150.00 - $325.00
D8692 – Replacement of lost or broken retainer - $180.00 - $460.00
D8694 – Repair of fixed retainers, includes reattachment - $75.00 - $200.00
D9951 – Occlusal adjustment – limited – equilibration - $350.00 - $650.00 per adjustment
D9952 – Occlusal adjustment – complete – equilibration – study models - $350.00 - $650.00 per adjustment