Fee Schedule

Email: drq@vipsperio.com

Fee Schedule
  • The following is a list of ADA procedure codes with the associated fee ranges.  I find that it is best for the patient to have both the exact fee for the procedure, as well as the financial arrangements made prior to scheduling any appointments with our office.  We may need to discuss these issues together to find what works best for your practice.

    CodeDescriptionFee Ranges*
    D6010Dental Implant$2000-2500.00
    D7210Extraction$300-500.00
    D4263Bone$500-800.00
    D4266Membrane$500-800.00
    D7951Sinus Life (Lateral)$2500-3000.00
    D7952Internal Sinus Lift$700-1000.00
    D4260Osseous 4+ teeth/quad$1500-2000.00
    D4261Osseous 1-3 teeth/quad$1100-1300.00
    D4270Pinhole Surgical Technique (per tooth)$600-800.00
    D4273Connective Tissue Graft (1)$1000-1400.00
    D4273Connective Tissue Graft (2-4)$2200-2800.00
    D4249Clinical Crown Lengthening (1)$1000-1100.00
    D4249Clinical Crown Lengthening (2-4)$2200-2700.00
    D4210Gingivectomy (1-3)$1000-1400.00
    D4212Gingivectomy (4+ teeth/quad)$1800-2300.00
    D7961Buccal Frenectomy$500-600.00
    D7962Lingual Frenectomy$500-600.00
    D4240Gingival Flap$500-800.00
    D7286Soft Tissue Biopsy$200-300.00
    D4274Distal Wedge$600-700.00
    D7291Supracrestal Fiberotomy$500-600.00
    D7280Surgical/Access/Unerupted$500-700.00
    D7261Sinus Closure$300-500.00
    D7310Alveoloplasty (per quad)

    $400-500.00

    D4275Allograft (Alloderm)$2200-2800.00

Board Certified Periodontist

Specialist in Periodontics & Implantology