72111 Single tooth
| 70000 | ORAL MAXILLOFACIAL SURGERY |
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| 72000 | REMOVALS, (EXTRACTIONS), SURGICAL |
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| 72100 | REMOVALS, IMPACTIONS, SOFT TISSUE COVERAGE |
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| 72110 | Removals, Impaction, Requiring Incision of Overlying Soft Tissue and Removal of The Tooth |
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| 72111 | Single tooth | $252.86 | $252.86 |