23310 Permanent Bicuspids
| 20000 | RESTORATION |
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| 23000 | RESTORATIONS, TOOTH COLOURED/PLASTIC WITH/WITHOUT SILVER FILINGS |
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| 23300 | RESTORATIONS, TOOTH COLORED, PERMANENT POSTERIORS - BONDED |
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| 23310 | Permanent Bicuspids | ||
| 23311 | One surface |
149.39 | 149.39 |
| 23312 | Two surfaces |
208.11 | 208.11 |
| 23313 | Three surfaces |
243.73 | 243.73 |
| 23314 | Four surfaces |
300.86 | 300.86 |
| 23315 | Five surfaces or maximum surface per tooth |
341.76 | 341.76 |