23210 Permanent Bicuspids

20000

RESTORATION

23000

RESTORATIONS, TOOTH COLOURED/PLASTIC WITH/WITHOUT SILVER FILINGS

23200

RESTORATIONS, TOOTH COLOURED/ PLASTIC WITH/WITHOUT SILVER FILINGS, PERMANENT
POSTERIORS NON BONDED

23210 Permanent Bicuspids
23211

One surface

114.7 114.7
23212

Two surfaces

145.99 145.99
23213

Three surfaces

183.54 183.54
23214

Four surfaces

221.11 221.11
23215

Five surfaces or maximum surface per tooth

232.57 232.57
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