Oral Surgery
| D7110 | Single Tooth Extraction | $36.00 |
| D7120 | Each Additional Tooth | $34.00 |
| D7130 | Root Removal - Exposed Roots | $48.00 |
| D7210 | Surgical Extraction - Erupted | $68.00 |
| D7220 | Removal of Impacted Tooth - Soft Tissue | $78.00 |
| D7230 | Removal of Impacted Tooth - Partially Bony | $109.00 |
| D7240 | Removal of Impacted Tooth - Completely Bony | $129.00 |
| D7241 | Removal of Impacted Tooth - Completely Bony, with Unusual Surgical Complications | $189.00 |
| D7250 | Root Recovery | $72.00 |
| D7280 | Surgical Exposure per Tooth | $66.00 |
| D7310 | Alveoloplasty (per Quadrant, with Extractions) |
$78.00 |
| D7320 | Alveoloplasty (per Quadrant, without Extractions) |
$84.00 |
| D7960 | Frenectomy | $99.00 |
A specific oral surgery treatment may present unusual circumstances requiring an additional cost. Please consult the affiliated dentist as to the total procedure cost prior to treatment.