20110 Caries/Trauma/Pain Control

20000

RESTORATION

20100

CARIES, TRAUMA AND PAIN CONTROL

20110 Caries/Trauma/Pain Control
Additional Information: Add'l Info:

(removal of carious lesions or existing restorations or gingivally attached tooth fragment and
placement of sedative/protective dressings, includes pulp caps when necessary, as a separate
procedure).

20111

First tooth

83.42 - 166.84 83.42 - 166.84
20119

Each additional tooth same quadrant

83.42 - 166.84 83.42 - 166.84
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