D7140 Extraction, erupted tooth or exposed root 5 x = $0.00 D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning tooth, and including elevation of mucoperiosteal flap 5 x = $0.00 D7220 Removal of impacted tooth-soft tissue 5 x = $0.00 D7230 Removal of impacted tooth – partially bony 10 x = $0.00 D7240 Removal of impacted tooth – complete bony 10 x = $0.00 D7241 Removal of impacted tooth- completely bony with unusual surgical complications 5 x = $0.00 D7250 Removal of residual roots(cutting procedure) 5 x = $0.00 D725 Coronectomy-intentional partial tooth removal 1 x = $0.00 D7260 Oroantral fistula closure 1 x = $0.00 D7261 Primary closure of Sinus Perforation 1 x = $0.00 D7285 Incisional Biopsy of oral tissue – hard (bone, tooth) 3 x = $0.00 D7286 Incisional Biopsy of oral tissue –soft 5 x = $0.00 D7287 Exfoliative cytological sample collection 5 x = $0.00 D7288 Brush biopsy 5 x = $0.00 D7311 Alveoplasty in conjunction with extraction- one to three teeth or tooth spaces per quadrant 1 x = $0.00 D7310 Alveoplasty in conjunction with extraction – four or more teeth or tooth spaces, per quadrant 1 x = $0.00 D7410 Excision of benign lesion up to 1.25 cm 5 x = $0.00 D7411 Excision of benign lesion greater than 1.25 cm 3 x = $0.00 D7450 Removal of benign odontogenic cyst or tumor – lesion diameter up to 1.25 cm 1 x = $0.00 D7451 Removal of benign odontogenic cyst or tumor – lesion diameter greater than 1.25cm 1 x = $0.00 D7460 Removal of benign non-odontogenic tumor or cyst – lesion diameter up to 1.25cm 1 x = $0.00 D7461 Removal of benign non-odontogenic tumor or cyst – lesion diameter greater than 1.25 am 1 x = $0.00 D7510 Incision and drainage of abscess – intraoral soft tissue 2 x = $0.00 D7511 Incision and drainage of abscess –intraoral soft tissue – complicated (includes drainage of multiple fascial spaces) 2 x = $0.00 70355 Panorex X-ray 20 x = $0.00 D0220 Intraoral Periapical Film 5 x = $0.00 D9310 Specialty Consultation 5 x = $0.00 MISC. Authorized Procedures 5 x = $0.00
