20120 Caries/Trauma/Pain Control

20000

RESTORATION

20100

CARIES, TRAUMA AND PAIN CONTROL

20120 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 and the use of a band
for retention and support, as a separate procedure)

20121

First tooth

125.14 - 208.56 125.14 - 208.56
20129

Each additional tooth same quadrant

125.14 - 208.56 125.14 - 208.56
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