New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 56 - MANUAL FOR DENTAL SERVICES
Subchapter 3 - HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS)
Section 10:56-3.10 - D7000-D7999 ORAL SURGERY
Current through Register Vol. 56, No. 18, September 16, 2024
(a) Extractions--includes local anesthesia and routine post-operative care:
| Maximum Fee | ||||||
| HCPCS | Allowance | |||||
| IND | Code | Mod | Procedure Description | S | $ | NS |
| D7110 | Single Tooth | 32.00 | 30.00 | |||
| D7120 | Extraction--each additional tooth | 32.00 | 30.00 | |||
| D7130 | Root Removal--Exposed Roots | 19.50 | 18.00 | |||
NOTE 1: Per tooth.
(b) Surgical extractions--includes local anesthesia and routine post-operative care:
| # | D7210 | Surgical Removal of Erupted Tooth | 33.00 | 31.00 |
| Requiring Elevation of | ||||
| Mucoperiosteal Flap and Removal of | ||||
| Bone and/or Section of Tooth | ||||
| # | D7220 | Removal of Impacted Tooth--Soft | 43.00 | 40.00 |
| Tissue | ||||
| # | D7230 | Removal of Impacted | 114.00 | 106.00 |
| Tooth--Partially Bony | ||||
| # | D7240 | Removal of Impacted | 114.00 | 106.00 |
| Tooth--Completely Bony | ||||
| # | D7250 | Surgical Removal of Residual Tooth | 43.00 | 39.00 |
| Roots (Cutting Procedure) |
NOTE: Includes cutting of soft tissue and bone, removal of tooth structure and closure.
(c) Other surgical procedures:
| D7260 | Oroantral Fistula Closure | 108.00 | 99.00 |
NOTE 1: Code may also be used for antral root recovery.
NOTE 2: Excision of fistulous tract between maxillary sinus and oral cavity and closure by advancement flap.
| D7270 | Tooth Re-implantation and/or | 93.00 | 85.00 | |
| Stabilization of Accidentally | ||||
| Avulsed or Displaced Tooth and/or | ||||
| Alveolus | ||||
| D7280 | Surgical Exposure of Impacted or | 101.00 | 94.00 | |
| Unerupted Tooth for Orthodontic | ||||
| Reason (Including Orthodontic | ||||
| Attachments) | ||||
| D7281 | Surgical Exposure of Impacted or | 45.00 | 41.00 | |
| Unerupted Tooth to Aid Eruption | ||||
| d | D7285 | Biopsy of Oral Tissue--Hard | 30.00 | 26.00 |
NOTE: Independent procedure (laboratory must bill separately).
| d | D7286 | Biopsy of Oral Tissue-Soft | 18.00 | 16.00 |
NOTE: Independent procedure (laboratory must bill separately).
(d) Alveoloplasty surgical preparation of ridge for dentures:
| D7310 | Alveoloplasty in Conjunction with | 62.50 | 56.50 |
| Extractions--Per Quadrant |
NOTE 1: In conjunction with extractions of at least three teeth or the roots of at least three teeth in the same quadrant.
NOTE 2: Specify quadrant.
| D7320 | Alveoloplasty Not In Conjunction | 62.50 | 56.50 |
| with extraction--Per Quadrant |
(e) Vestibuloplasty--including revision of soft tissues on ridges, muscle reattachment, tongue, palate, and other oral soft tissues (complete description including size and position must be submitted). Reimbursement will be based upon quadrants.
| D7340 | Vestibuloplasty--Ridge Extension | 65.00 | 59.00 |
| (Secondary Epithelialization) |
NOTE: Including management of hypertrophied and hyperplastic tissue, per quadrant.
| D7350 | Vestibuloplasty--Ridge Extension | 169.00 | 153.00 |
| (Including Soft Tissue Grafts, | |||
| Muscle Re-attachments, Revision of | |||
| Soft Tissue Attachment, and | |||
| Management of Hypertrophied and | |||
| Hyperplastic Tissue) |
NOTE: Per Quadrant.
(f) Surgical excision of reactive inflammatory lesions (scar tissue or localized congenital lesions):
NOTE: Biopsy report must be available upon request for review by the Division's dental consultants.
| D7410 | Radical Excision--Lesion Diameter | 30.00 | 26.00 |
| Up to 1.25 cm. | |||
| D7420 | Radical Excision--Lesion Diameter | 42.00 | 37.00 |
| Over 1.25 cm. |
NOTE: Up to and including three cm.
| D7420 | 22 | Radical Excision--Lesion Diameter | 100.00 | 86.00 |
| Over 3 cm. |
(g) Removal of tumors, cysts, and neoplasms:
| D7430 | Excision of Benign Tumor--Lesion | 30.00 | 26.00 |
| Diameter Up to 1.25 cm. | |||
| D7431 | Excision of Benign Tumor--Lesion | 42.00 | 37.00 |
| Diameter Over 1.25 cm. |
| D7431 | 22 | Excision of Benign Tumor--Lesion | 100.00 | 86.00 |
| Diameter Over 3 cm. | ||||
| D7440 | Excision of Malignant | 100.00 | 86.00 | |
| Tumor--Lesion Diameter Up to 1.25 | ||||
| cm. | ||||
| D7441 | Excision of Malignant | 274.00 | 256.00 | |
| Tumor--Lesion Diameter Over 1.25 | ||||
| cm. |
NOTE: Up to and including three cm.
| D7441 | 22 | Excision of Malignant | 473.00 | 413.00 |
| Tumor--Lesion Diameter Over 3 cm. | ||||
| D7450 | Removal of Odontogenic Cyst or | 50.00 | 43.00 | |
| Tumor--Lesion Diameter Up to 1.25 | ||||
| cm. | ||||
| D7451 | Removal of Odontogenic Cyst or | 100.00 | 87.00 | |
| Tumor--Lesion Diameter Over 1.25 | ||||
| cm. |
NOTE: Up to and including three cm.
| D7451 | 22 | Removal of Odontogenic Cyst or | 150.00 | 130.00 |
| Tumor--Lesion Diameter Over 3 cm. | ||||
| D7460 | Removal of Non Odontogenic Cyst or | 50.00 | 43.00 | |
| Tumor--Lesion Diameter Up to 1.25 | ||||
| cm. | ||||
| D7461 | Removal of Non Odontogenic Cyst or | 100.00 | 87.00 | |
| Tumor--Lesion Diameter Over 1.25 | ||||
| cm. |
NOTE: Up to and including three cm.
| D7461 | 22 | Removal of Non Odontogenic Cyst or | 150.00 | 130.00 |
| Tumor--Lesion Diameter Over 3 cm. | ||||
| D7465 | Destruction of Lesion(s) by | 18.00 | 15.00 | |
| Physical Methods: Electrosurgery, | ||||
| Chemotherapy, Cryotherapy or Laser |
(h) Excision of bone tissue:
| D7471 | Removal of Exostosis--per site | 62.50 | 56.50 |
NOTE: Per quadrant.
| D7471 | 22 | Removal of Exostosis | 109.00 | 98.00 |
NOTE: Torus palatinus.
| D7480 | Partial Ostectomy (Guttering or | 211.00 | 184.00 |
| Saucerization) | |||
| D7490 | Radical Resection of Mandible with | 807.00 | 807.00 |
| Bone Graft |
(i) Surgical incision:
| D7510 | Incision and Drainage of | 28.00 | 26.00 |
| Abscess--Intraoral Soft Tissue | |||
| D7520 | Incision and Drainage of | 42.00 | 37.00 |
| Abscess--Extraoral Soft Tissue | |||
| D7530 | Removal of Foreign Body, Skin, or | 18.00 | 16.00 |
| Subcutaneous Areolar Tissue | |||
| D7540 | Removal of Reaction Producing | 51.00 | 45.00 |
| Foreign Bodies, Musculoskeletal | |||
| System | |||
| D7550 | Sequestrectomy for Osteomyelitis | 48.00 | 42.00 |
NOTE: Intraoral.
| D7550 | 22 | Sequestrectomy for Osteomyelitis | 90.00 | 75.00 |
NOTE: Extraoral.
| D7560 | Maxillary Sinusotomy for Removal | 242.00 | 210.00 |
| of Tooth Fragment or Foreign Body |
NOTE: Sinusotomy, maxillary (antrotomy, Caldwell Luc, unilateral).
(j) Treatment of fractures--simple:
| D7610 | Maxilla--Open Reduction (Teeth | 273.00 | 249.00 | |
| Immobilized if Present) | ||||
| D7620 | Maxilla--Closed Reduction (Teeth | 182.00 | 166.00 | |
| Immobilized if Present) | ||||
| D7620 | 52 | Maxilla--Closed Reduction | 80.00 | 76.00 |
NOTE: No manipulation or fixation.
| D7630 | Mandible--Open Reduction (Teeth | 363.00 | 331.00 | |
| Immobilized if Present) | ||||
| D7630 | 22 | Mandible--Open Reduction (Teeth | 454.00 | 414.00 |
| Immobilized if Present) |
NOTE: Complicated--multiple surgical approaches (three or more) including internal fixation, interdental fixation, skeletal pinning with extraoral fixation.
| D7640 | Mandible--Closed Reduction (Teeth | 182.00 | 166.00 | |
| Immobilized if Present) | ||||
| D7640 | 52 | Mandible--Closed Reduction | 80.00 | 76.00 |
NOTE: No manipulation or fixation.
| D7650 | Malar and/or Zygomatic Arch--Open | 182.00 | 166.00 |
| Reduction | |||
| D7660 | Malar and/or Zygomatic | 63.00 | 58.00 |
| Arch--Closed Reduction |
NOTE: Including towel clip technique.
| D7660 | 52 | Malar and/or Zygomatic | 56.00 | 52.00 |
| Arch--Closed Reduction |
NOTE: No manipulation or fixation.
| D7670 | Alveolus--Stabilization of Teeth, | 138.00 | 126.00 |
| Open Reduction Splinting |
NOTE 1: Alveolar fracture.
NOTE 2: Reduction with wiring, application of arch bar or splint.
| D7680 | Facial Bones--Complicated | 363.00 | 331.00 |
| Reduction with Fixation and | |||
| Multiple Surgical Approaches |
NOTE 1: Maxilla, malar and/or zygomatic arch.
NOTE 2: Multiple surgical approaches (three or more), fixation, traction, head frame, multiple internal and/or external fixation, and head cap.
(k) Treatment of fractures--compound:
| D7710 | Maxilla--Open Reduction | 273.00 | 249.00 |
NOTE: Teeth immobilized if present.
| D7720 | Maxilla--Closed Reduction | 182.00 | 166.00 |
NOTE: Teeth immobilized if present.
| D7720 | 52 | Maxilla--Closed Reduction | 80.00 | 76.00 |
NOTE: No manipulation or fixation.
| D7730 | Mandible--Open Reduction | 363.00 | 331.00 |
NOTE: Teeth immobilized if present.
| D7730 | 22 | Mandible--Open Reduction | 454.00 | 414.00 |
NOTE: Complicated--multiple surgical approaches (three or more) including internal fixation, interdental fixation, and skeletal pinning with extraoral fixation.
| D7740 | Mandible--Closed Reduction | 182.00 | 166.00 |
NOTE: Teeth immobilized if present.
| D7740 | 52 | Mandible--Closed Reduction | 80.00 | 76.00 |
NOTE: No manipulation or fixation.
| D7750 | Malar and/or Zygomatic Arch--Open | 182.00 | 166.00 |
| Reduction | |||
| D7760 | Malar and/or Zygomatic | 63.00 | 58.00 |
| Arch--Closed Reduction |
NOTE: Including towel clip technique.
| D7760 | 52 | Malar and/or Zygomatic | 56.00 | 52.00 |
| Arch--Closed Reduction |
NOTE: No manipulation or fixation.
| D7770 | Alveolus--Stabilization of Teeth, | 138.00 | 126.00 |
| Open Reduction Splinting |
NOTE 1: Alveolar fracture.
NOTE 2: Reduction with wiring, application of arch bar or splint.
| D7780 | Facial Bones--Complicated | 363.00 | 331.00 |
| Reduction with Fixation and | |||
| Multiple Surgical Approaches |
NOTE 1: Maxilla, malar and/or zygomatic arch.
NOTE 2: Multiple surgical approaches (three or more), fixation, traction, head frame, multiple internal and/or external fixation, and head cap.
(l) Reduction of dislocation and management of other temporo-mandibular joint dysfunctions:
| D7810 | Open Reduction of Dislocation | 273.00 | 249.00 | |
| D7820 | Closed Reduction of Dislocation | 27.00 | 25.00 | |
| d | D7830 | Manipulation under Anesthesia | 27.00 | 25.00 |
NOTE: Anesthesia additional.
| D7840 | Condylectomy | 362.00 | 315.00 |
| D7850 | Meniscectomy | 362.00 | 315.00 |
| D7852 | Disc repair | 362.00 | 308.00 |
NOTE: Unilateral.
| D7854 | Synovectomy | 200.00 | 173.00 |
| D7858 | Joint reconstruction | 623.00 | 623.00 |
| D7860 | Arthrotomy | 182.00 | 155.00 |
| D7865 | Arthroplasty | 362.00 | 308.00 |
NOTE: Unilateral.
| d | D7870 | Arthrocentesis | 18.00 | 16.00 |
NOTE: Injection or aspiration (give complete details).
| D7871 | Non-arthroscopic lysis and lavage | 190.00 | 190.00 | |
| D7872 | Arthroscopy--diagnosis, with or | 75.00 | 65.00 | |
| without biopsy | ||||
| D7873 | Arthroscopy--surgical: lavage and | 200.00 | 200.00 | |
| lysis of adhesions | ||||
| D7874 | Arthroscopy--surgical: disc | 500.00 | 425.00 | |
| repositioning and stabilization | ||||
| D7875 | Arthroscopy--surgical: synovectomy | 264.00 | 224.00 | |
| D7877 | Arthroscopy--surgical: debridement | 160.00 | 136.00 | |
| * | D7880 | Occlusal orthotic device, by report | BR | BR |
| D7899 | Unspecified TMD therapy, by report | BR | BR |
(m) Repair of traumatic wounds:
| D7910 | Suture of Recent Small Wounds up | 35.00 | 32.00 |
| to 5 cm. |
NOTE: 2.5 cm. up to five cm.
(n) Complicated suturing (reconstruction requiring delicate handling of tissues and wide undermining for meticulous closure):
| D7911 | Complicated suture--Up to 5 cm. | 138.00 | 138.00 |
| D7912 | Complicated suture--greater than 5 | 242.00 | 242.00 |
| cm. | |||
| D7920 | Skin graft (identify defect | 70.50 | 70.50 |
| covered, location and type of | |||
| graft) |
(o) Other repair procedures:
| D7940 | Osteoplasty--For Orthognathic | 225.00 | 191.00 |
| Deformities | |||
| D7941 | Osteotomy--Mandibular rami | 726.00 | 726.00 |
NOTE: Unilateral.
| D7943 | Osteotomy--Mandibular rami with | 1,058 | 1,058 |
| bone graft; includes obtaining the | |||
| graft |
NOTE: Unilateral.
| D7944 | Osteotomy--Segmented or | 332.00 | 289.00 | |
| subapical--per sextant or quadrant | ||||
| D7945 | Osteotomy--body of mandible | 332.00 | 289.00 | |
| D7946 | LeFort I (maxilla--total) | 546.00 | 546.00 | |
| * | D7947 | LeFort I (maxilla--segmented) | 365.00 | 365.00 |
| D7948 | LeFort II or LeFort III | 1,095 | 1,095 | |
| (Osteoplasty of facial bones for | ||||
| midface Hypoplasia or | ||||
| retrusion)--without bone graft | ||||
| D7949 | LeFort II or LeFort III--with bone | 1,427 | 1,427 | |
| graft | ||||
| D7950 | Osseous, osteoperiosteal, or | 575.00 | 489.00 | |
| cartilage graft of the mandible or | ||||
| facial bones--autogenous or | ||||
| nonautogenous, by report | ||||
| D7955 | Repair of Maxillofacial Soft and | 203.00 | 176.00 | |
| Hard Tissue Defects | ||||
| D7960 | Frenulectomy (Frenectomy or | 60.00 | 56.00 | |
| Frenotomy)--Separate Procedure | ||||
| D7970 | Excision of hyperplastic | 45.00 | 39.00 | |
| tissue--per arch | ||||
| D7971 | Excision of pericoronal gingiva | 42.00 | 37.00 | |
| D7980 | Sialolithotomy | 48.00 | 42.00 | |
| D7981 | Excision of Salivary Gland, by | 182.00 | 158.00 | |
| report | ||||
| D7982 | Sialodochoplasty | 151.00 | 131.00 | |
| D7983 | Closure of Salivary Fistula | 151.00 | 131.00 | |
| D7990 | Emergency Tracheotomy | 121.00 | 105.00 | |
| D7991 | Coronoidectomy | 362.00 | 308.00 | |
| * | D7995 | Synthetic graft--mandible or | BR | BR |
| facial bones, by report | ||||
| D7996 | Implant--mandible for augmentation | BR | BR | |
| purposes (excluding alveolar | ||||
| ridge), by report | ||||
| D7997 | Appliance removal (not by dentist | 151.00 | 151.00 | |
| who placed appliance), includes | ||||
| removal of archbar | ||||
| ** | D7999 | Unspecified Oral Surgery | BR | BR |
| Procedure, By Report |
NOTE: Complete description of procedure and the reason the procedure was performed.
