| 7 | Use of any type of own equipment in the rooms / | 54 | Dentist | 169.30 |
| 200 | Medicine | 54 | Dentist | – |
| 201 | Cost of material/Contact lens fitting:Basic:Monocul. | 54 | Dentist | – |
| 3366 | Rotation tomography of teeth and jaws. | 54 | Dentist | 212.80 |
| 4567 | Anatomic Pathology: Histology; one unit or sample | 54 | Dentist | 189.50 |
| 4589 | Anatomic Pathology: Special stains | 54 | Dentist | 64.00 |
| 5930 | Surgical Laser Apparatus: Hire fee for OWN equipment | 54 | Dentist | 1,230.30 |
| 6460 | CT for dental implants maxilla OR mandible | 54 | Dentist | – |
| 6462 | CT angiography per limited region (incl. spiral etc) | 54 | Dentist | – |
| 8099 | Dental technician fees. | 54 | Dentist | – |
| 8101 | Full examination and charting and treatment planning | 54 | Dentist | 183.80 |
| 8102 | Comprehensive Consultation | 54 | Dentist | 296.70 |
| 8104 | Consultation for a specific problem not requiring | 54 | Dentist | 89.10 |
| 8106 | Provision of a written treatment plan and quotation | 54 | Dentist | 188.80 |
| 8107 | Intra-oral radiographs | 54 | Dentist | – |
| 8108 | Full mouth intra-oral x-rays (maximum). | 54 | Dentist | 576.00 |
| 8109 | Infection control | 54 | Dentist | 16.50 |
| 8110 | Prov. of sterilised and wrapped instrumentation | 54 | Dentist | 42.60 |
| 8112 | Intraoral radiograph-bitewing | 54 | Dentist | 74.40 |
| 8113 | Occlusal radiographs | 54 | Dentist | 128.20 |
| 8114 | Hand-wrist Radiograph | 54 | Dentist | 297.50 |
| 8115 | Extra-oral radiograph – per film | 54 | Dentist | – |
| 8116 | Extraoral radiograph-cephalometric | 54 | Dentist | 297.50 |
| 8117 | Study models – unmounted or mounted on a hinge/art. | 54 | Dentist | 80.00 |
| 8118 | Extraoral radiograph-skull/facial bone | 54 | Dentist | 297.50 |
| 8119 | Study models-mounted on a moveable condyle articul. | 54 | Dentist | 201.10 |
| 8121 | Photographs-per photograph(diagnostic | 54 | Dentist | 80.00 |
| 8123 | Caries susceptibility tests | 54 | Dentist | 83.00 |
| 8124 | Pulp vitality test | 54 | Dentist | 21.90 |
| 8129 | Add. fee for emergency treatment outside normal hrs. | 54 | Dentist | 276.90 |
| 8131 | Emerg. treatment where no other treatment item is | 54 | Dentist | 112.80 |
| 8132 | Root canal therapy -gross pulpal debridement | 54 | Dentist | 184.50 |
| 8133 | Recementing of inlay- crown or bridge per unit. | 54 | Dentist | 112.80 |
| 8135 | Removal of inlay or crown per unit. | 54 | Dentist | 224.50 |
| 8136 | Access through a prosthetic crown or inlay | 54 | Dentist | 100.70 |
| 8137 | Temporary crown placed as an emergency procedure | 54 | Dentist | 387.10 |
| 8138 | Remove retention post (prefabricated or cast) | 54 | Dentist | 147.40 |
| 8140 | Treatment at a venue other than the surgery | 54 | Dentist | 183.40 |
| 8141 | Inhal. sedation/electronic analgesia – 1st 15 min | 54 | Dentist | 82.70 |
| 8143 | Each additional 15 minutes. | 54 | Dentist | 42.60 |
| 8144 | Intravenous sedation. | 54 | Dentist | 49.50 |
| 8145 | Local anaesthetic per visit | 54 | Dentist | 71.70 |
| 8147 | Use of own monitoring equipment in rooms for proce | 54 | Dentist | 176.40 |
| 8151 | Oral hygiene instructions | 54 | Dentist | 112.80 |
| 8153 | Follow-up visit for re-evaluation of oral hygiene | 54 | Dentist | 82.70 |
| 8155 | Polishing only | 54 | Dentist | 112.80 |
| 8157 | Reburnishing/polishing of restorations. | 54 | Dentist | 112.80 |
| 8158 | Enamel microabrasion | 54 | Dentist | 103.20 |
| 8159 | Scaling and polishing | 54 | Dentist | 222.00 |
| 8161 | Topical application of fluoride-child | 54 | Dentist | 112.80 |
| 8162 | Topical application of fluoride-adult (12 years >) | 54 | Dentist | 112.80 |
| 8163 | Fissure sealant: per tooth | 54 | Dentist | – |
| 8165 | Sedative filling | 54 | Dentist | 112.80 |
| 8166 | Application of desenitising resin per tooth | 54 | Dentist | 74.40 |
| 8167 | Treatment of hypersensitive dentine | 54 | Dentist | 86.70 |
| 8169 | Bite plate or occlusal guards | 54 | Dentist | 433.90 |
| 8171 | Mouth protectors (No benefit). | 54 | Dentist | 131.30 |
| 8172 | Cost of orthotic device | 54 | Dentist | – |
| 8173 | Fixed space maintainers per abutment unit | 54 | Dentist | 209.50 |
| 8175 | Removable space maintainer (all inclusive fee). | 54 | Dentist | 270.00 |
| 8176 | Periodontal Screening | 54 | Dentist | 154.80 |
| 8177 | Oral hygiene instruction for the periodontally | 54 | Dentist | 170.90 |
| 8178 | Oral hygiene evaluation for the periodontally | 54 | Dentist | 92.20 |
| 8179 | Plaque removal for the periodontally compromised | 54 | Dentist | 129.50 |
| 8180 | Scaling & polishing for period. compromised patient | 54 | Dentist | 241.00 |
| 8183 | Intra-muscular or sub-cut. injection therapy. | 54 | Dentist | 49.50 |
| 8184 | Root planing with or without period. currett. | 54 | Dentist | – |
| 8185 | Gingivectomy-gingivoplasty. | 54 | Dentist | – |
| 8186 | Gingivectomy-gingivoplasty. | 54 | Dentist | – |
| 8189 | Re-examination existing condition-GDP | 54 | Dentist | 89.10 |
| 8190 | Consultation-GDP | 54 | Dentist | 183.80 |
| 8192 | Appositioning (suturing) of soft tissue injuries | 54 | Dentist | 556.40 |
| 8201 | Extractions: Single tooth/Proprietary homeopathic | 54 | Dentist | 112.80 |
| 8202 | Each additional tooth in the same quadrant/ | 54 | Dentist | 45.40 |
| 8210 | Unerupted/Impacted teeth: First tooth | 54 | Dentist | – |
| 8213 | Surgical removal of residual roots (cutting proced) | 54 | Dentist | 487.90 |
| 8214 | Surg. removal of residual roots:each subseq. tooth | 54 | Dentist | 376.10 |
| 8220 | Use of suture provided by practitioner (see note 4) | 54 | Dentist | – |
| 8231 | Full upper and lower dentures incl.soft/metal bases | 54 | Dentist | 1,821.00 |
| 8232 | Full upper or lower dentures incl. soft/metal bases | 54 | Dentist | 1,122.50 |
| 8233 | Partial denture: One tooth. | 54 | Dentist | 522.10 |
| 8234 | Partial denture: Two teeth. | 54 | Dentist | 522.10 |
| 8235 | Partial denture: Three teeth. | 54 | Dentist | 781.00 |
| 8236 | Partial denture: Four teeth | 54 | Dentist | 781.00 |
| 8237 | Partial denture: Five teeth. | 54 | Dentist | 781.00 |
| 8238 | Partial denture: Six teeth. | 54 | Dentist | 1,035.90 |
| 8239 | Partial denture: Seven teeth. | 54 | Dentist | 1,035.90 |
| 8240 | Partial denture: Eight teeth. | 54 | Dentist | 1,035.90 |
| 8241 | Partial denture: Nine or more teeth. | 54 | Dentist | 1,035.90 |
| 8244 | Immediate Denture – maxillary | 54 | Dentist | 1,122.50 |
| 8245 | Immediate Denture – mandibular | 54 | Dentist | 1,122.50 |
| 8251 | Cast rest or clasp gold per rest or clasp. | 54 | Dentist | 103.20 |
| 8253 | Wrought gold clasp or rest per clasp or rest | 54 | Dentist | 103.20 |
| 8255 | Stainless steel clasp or rest per clasp or rest. | 54 | Dentist | 108.80 |
| 8257 | Lingual or palatal bar. | 54 | Dentist | 128.20 |
| 8259 | Reline of denture (laboratory) | 54 | Dentist | 425.60 |
| 8261 | Remodelling per denture. | 54 | Dentist | 683.30 |
| 8263 | Reline of denture in selfcuring acrylic (intra-oral) | 54 | Dentist | 270.00 |
| 8265 | Tissue conditioner | 54 | Dentist | 176.40 |
| 8267 | Reline complete or partial denture (laboratory) | 54 | Dentist | 621.30 |
| 8269 | Repair of denture or other intra-oral appl. | 54 | Dentist | 143.30 |
| 8270 | Add clasp to existing partial denture | 54 | Dentist | 103.20 |
| 8271 | Additional tooth to existing partial denture | 54 | Dentist | 103.20 |
| 8273 | Add fee for impression for 8269/8270/8271/8846 | 54 | Dentist | 82.70 |
| 8275 | Adjustment of denture | 54 | Dentist | 82.70 |
| 8281 | Metal base to partial denture. | 54 | Dentist | 1,217.60 |
| 8301 | Direct pulp capping/Consultation Duration 1-15 mins | 54 | Dentist | 150.20 |
| 8303 | Indirect pulp capping/Consultation Duration 31-45 m | 54 | Dentist | 150.20 |
| 8304 | Rubber dam – per arch/Consultation Duration 46 -60m | 54 | Dentist | 88.20 |
| 8306 | Cost of Mineral Trioxide Aggregate | 54 | Dentist | – |
| 8307 | Amputation of pulp (pulpotomy) | 54 | Dentist | 147.40 |
| 8325 | Bleaching of non-vital teeth per tooth – 1st visit. | 54 | Dentist | 267.20 |
| 8327 | Each additional visit for non-vital bleaching. | 54 | Dentist | – |
| 8328 | Each add. canal – anteriors and premolars | 54 | Dentist | 209.50 |
| 8329 | Each additional canal – anteriors and premolars | 54 | Dentist | 261.80 |
| 8330 | Removal of fractured post or instrument | 54 | Dentist | 147.40 |
| 8332 | Anterior teeth inclusive of premolars – per visit | 54 | Dentist | – |
| 8333 | Multi-canal tooth – per visit | 54 | Dentist | – |
| 8334 | Re-preparation of previously obturated canal | 54 | Dentist | 166.70 |
| 8335 | First canal – anteriors and premolars | 54 | Dentist | 512.40 |
| 8336 | First canal – molars | 54 | Dentist | 705.30 |
| 8337 | Each additional canal – molars | 54 | Dentist | 209.50 |
| 8338 | First canal – anteriors and premolars | 54 | Dentist | 784.00 |
| 8339 | First canal – molars | 54 | Dentist | 1,077.20 |
| 8340 | Each additional canal – molars | 54 | Dentist | 261.80 |
| 8341 | Plastic restorations: Amalgam – one surface | 54 | Dentist | 224.50 |
| 8342 | Plastic restorations: Amalgam – two surfaces | 54 | Dentist | 276.90 |
| 8343 | Plastic restorations: Amalgam – three surfaces | 54 | Dentist | 337.50 |
| 8344 | Plastic restoration:Amalgam – four or more surfaces | 54 | Dentist | 376.10 |
| 8345 | Preformed post retention per post | 54 | Dentist | 222.00 |
| 8347 | Pin retention for restoration | 54 | Dentist | 111.70 |
| 8348 | Pin retention for restoration – each additional pin | 54 | Dentist | 103.20 |
| 8349 | Carving a plastic restoration to accommodate an | 54 | Dentist | 45.40 |
| 8350 | Resin crown-anterior primary tooth (direct) | 54 | Dentist | 490.00 |
| 8351 | Acid etch restoration: One surface. | 54 | Dentist | 246.60 |
| 8352 | Resin – two surfaces – anterior | 54 | Dentist | 310.10 |
| 8353 | Acid etch restoration: Three surfaces. | 54 | Dentist | 370.50 |
| 8354 | Acid etch restoration: more than three surfaces. | 54 | Dentist | 413.20 |
| 8355 | Composite veneers (direct) – No 8099. | 54 | Dentist | 391.40 |
| 8357 | Preformed metal crown. | 54 | Dentist | 230.10 |
| 8361 | Metal inlays on posterior teeth – one surface | 54 | Dentist | 342.90 |
| 8362 | Metal inlays on posterior teeth: Two surfaces | 54 | Dentist | 501.40 |
| 8363 | Metal inlays on posterior teeth: Three surfaces | 54 | Dentist | 835.90 |
| 8364 | Metal inlays on posterior teeth:Four or more surface | 54 | Dentist | 1,011.00 |
| 8366 | Pin retention as part of cast restoration; irresp | 54 | Dentist | 166.70 |
| 8367 | One surface on premolar or molar/Een vlak op voorkie | 54 | Dentist | 267.20 |
| 8368 | Two surfaces on premolar or molar/Twee vlakke | 54 | Dentist | 330.70 |
| 8369 | Three surfaces on premolar or molar/Drie vlakke | 54 | Dentist | 399.50 |
| 8370 | Four or more surfaces on premolar of molar | 54 | Dentist | 429.60 |
| 8371 | Ceramic/Resin bonded inlays/veneers – one surface. | 54 | Dentist | 413.20 |
| 8372 | Ceramic/Resin bonded inlays/veneers – 2 surfaces. | 54 | Dentist | 610.10 |
| 8373 | Ceramic/Resin bonded inlays/veneers – 3 surfaces/ | 54 | Dentist | 1,005.60 |
| 8374 | Ceramic and/or resin inlays/veneers – 4 surfaces | 54 | Dentist | 1,217.60 |
| 8375 | Prefabricated resin crown | 54 | Dentist | 230.10 |
| 8376 | Prefabricated post and core in addition to crown | 54 | Dentist | 614.40 |
| 8379 | Cost of posts – noble metals only | 54 | Dentist | – |
| 8381 | Inlay-resin-one surface | 54 | Dentist | 413.20 |
| 8382 | Inlay/Onlay-resin-two surfaces | 54 | Dentist | 610.10 |
| 8383 | Inlay/onlay-resin-three surfaces | 54 | Dentist | 1,005.60 |
| 8384 | Inlay/onlay-resin-four or more surfaces | 54 | Dentist | 1,217.60 |
| 8391 | Single post (thimble or coping). | 54 | Dentist | 259.20 |
| 8392 | Cast post (each additional) | 54 | Dentist | 154.20 |
| 8397 | Cast core with pins (not with 8137). | 54 | Dentist | 413.20 |
| 8398 | Core build-up including any pins | 54 | Dentist | 501.40 |
| 8401 | Cast full crown | 54 | Dentist | 1,289.20 |
| 8403 | Cast three-quarter crown | 54 | Dentist | 1,289.20 |
| 8404 | Crown 3/4 porcelain/ceramic | 54 | Dentist | 1,217.50 |
| 8405 | Acrylic jacket crown. | 54 | Dentist | 1,217.50 |
| 8407 | Acrylic veneered crown. | 54 | Dentist | 1,289.20 |
| 8409 | Porcelain jacket crown. | 54 | Dentist | 1,289.20 |
| 8410 | Provisional Crown | 54 | Dentist | 250.60 |
| 8411 | Porcelain veneered crown | 54 | Dentist | 1,289.20 |
| 8413 | Facing replacement (not with 8137). | 54 | Dentist | 250.60 |
| 8414 | Additional Fee for Crown with existing clasp | 54 | Dentist | 74.40 |
| 8415 | Pontic-porcelain/ceramic | 54 | Dentist | 1,052.50 |
| 8416 | Pontic-cast metal | 54 | Dentist | 835.90 |
| 8417 | Pontic-resin with metal | 54 | Dentist | 1,052.50 |
| 8418 | Pontic-porcelain fused to metal | 54 | Dentist | 1,052.50 |
| 8419 | Provisional pontic | 54 | Dentist | 250.60 |
| 8432 | Inlay/onlay retainer – netal – two surfaces | 54 | Dentist | 501.40 |
| 8433 | Inlay/onlay retainer – metal – three surfaces | 54 | Dentist | 835.90 |
| 8434 | Inlay/onlay retainer – metal – four or more surfaces | 54 | Dentist | 1,011.00 |
| 8436 | Inlay/onlay retainer – porcelain – two surfaces | 54 | Dentist | 610.10 |
| 8437 | Inlay/onlay retainer – porcelain – three surfaces | 54 | Dentist | 1,005.60 |
| 8438 | Inlay/onlay retainer – porcelain – four or more | 54 | Dentist | 1,217.60 |
| 8441 | Crown retainer – full cast metal | 54 | Dentist | 1,289.20 |
| 8442 | Crown retainer – 3/4 cast metal | 54 | Dentist | 1,289.20 |
| 8443 | Crow retainer – porcelain/ceramic | 54 | Dentist | 1,289.20 |
| 8444 | Crown retainer – 3/4 procelain/ceramic | 54 | Dentist | 1,289.20 |
| 8445 | Crown retainer – porcelain with metal | 54 | Dentist | 1,289.20 |
| 8446 | Crown retainer – resin with metal | 54 | Dentist | 1,289.20 |
| 8447 | Provisional crown retainer | 54 | Dentist | 250.60 |
| 8499 | The relevant MASA | 54 | Dentist | – |
| 8503 | Occlusal analysis on adjustable articulator. | 54 | Dentist | 250.60 |
| 8505 | Pantographic recording. | 54 | Dentist | 328.40 |
| 8508 | Electrognathographic recording. | 54 | Dentist | 351.60 |
| 8509 | Electrognathographic recording with comp. analysis. | 54 | Dentist | 646.40 |
| 8514 | Recement bridge | 54 | Dentist | 112.80 |
| 8515 | Recementing of crowns/inlays/bridges per abutment. | 54 | Dentist | 224.50 |
| 8516 | Remove bridge | 54 | Dentist | 224.50 |
| 8517 | Re-implantation of a tooth. | 54 | Dentist | 260.80 |
| 8518 | Repair bridge | 54 | Dentist | 250.60 |
| 8533 | Implant supported removable complete overdenture | 54 | Dentist | 2,023.90 |
| 8534 | Implant supported removable partial overdenture | 54 | Dentist | 1,619.30 |
| 8536 | Crown-implant/abutment supported-porcelain/ceramic | 54 | Dentist | 1,673.60 |
| 8537 | Crown-implant/abutment supported-porcelain with | 54 | Dentist | 1,673.60 |
| 8538 | Crown-implant/abutment supported-cast metal | 54 | Dentist | 1,673.60 |
| 8546 | Crown retainer-implant abutment supported-porcelain | 54 | Dentist | 1,673.60 |
| 8547 | Crown retainer-implant abutment supported-porcelain | 54 | Dentist | 1,673.60 |
| 8548 | Crown retainer-implant abutment supported-cast metal | 54 | Dentist | 1,673.60 |
| 8551 | Major occlusal adjustment. | 54 | Dentist | 714.30 |
| 8552 | Veneer-porcelain (laboratory) | 54 | Dentist | 865.80 |
| 8553 | Minor occlusal adjustment. | 54 | Dentist | 249.20 |
| 8554 | Bonded veneers – only with 8099. | 54 | Dentist | 865.80 |
| 8561 | Class I and Class VI gold foil restoration. | 54 | Dentist | 653.80 |
| 8563 | Class V gold foil restoration. | 54 | Dentist | 765.10 |
| 8565 | Class III gold foil restoration. | 54 | Dentist | 962.30 |
| 8578 | Prefabricated abutment | 54 | Dentist | 209.50 |
| 8579 | Custom abutment | 54 | Dentist | 955.10 |
| 8583 | Triple post + coping (+ 8099). | 54 | Dentist | – |
| 8584 | Connector bar-implant supported | 54 | Dentist | 2,023.90 |
| 8585 | Connector bar | 54 | Dentist | 2,023.90 |
| 8586 | Stress breaker | 54 | Dentist | 754.90 |
| 8587 | Copings (+ 8099). | 54 | Dentist | 168.20 |
| 8590 | Periodic maint. of existing implant prosthesis. | 54 | Dentist | 92.80 |
| 8594 | Repair implant supported prosthesis | 54 | Dentist | 102.90 |
| 8595 | Repair implant abutment | 54 | Dentist | 102.90 |
| 8597 | Locks and milled rests. | 54 | Dentist | 102.90 |
| 8599 | Precision attachments. | 54 | Dentist | 250.60 |
| 8617 | Retainer cast metal | 54 | Dentist | 501.40 |
| 8635 | Apexification of root canal – per visit. | 54 | Dentist | 150.20 |
| 8652 | Complete overdenture | 54 | Dentist | 2,023.90 |
| 8653 | Partial overdenture | 54 | Dentist | 1,619.30 |
| 8654 | Denture fxd impl/abut sup cmpl | 54 | Dentist | 2,276.70 |
| 8655 | Denture fxd impl/abut sup prtl | 54 | Dentist | 1,821.10 |
| 8657 | Replacement of precision attachment | 54 | Dentist | 143.30 |
| 8658 | Interim complete denture | 54 | Dentist | 1,122.50 |
| 8659 | Interim partial denture | 54 | Dentist | 898.10 |
| 8660 | Additional fee to implant supported fixed-detachable | 54 | Dentist | 314.20 |
| 8662 | Remounting and occlusal adjustment of dentures. | 54 | Dentist | 292.10 |
| 8663 | Chrome cobalt base or gold base for full denture | 54 | Dentist | 609.70 |
| 8664 | Remount of crown or bridge for ext. prosthetics. | 54 | Dentist | 292.10 |
| 8667 | Soft base – per denture. | 54 | Dentist | 609.70 |
| 8672 | Additional fee for altered model in partial denture. | 54 | Dentist | 78.30 |
| 8674 | Additive partial denture. | 54 | Dentist | 918.30 |
| 8723 | Provisional splinting – per sextant. | 54 | Dentist | 209.50 |
| 8725 | Provisional splinting – wire + resin – per sextant. | 54 | Dentist | 304.00 |
| 8727 | Provisional splinting – per tooth included. | 54 | Dentist | 95.50 |
| 8731 | Periodontal abscess – treatment acute phase. | 54 | Dentist | 180.00 |
| 8737 | Root planing -with/without periodontal curettage – | 54 | Dentist | 452.00 |
| 8739 | Root planing – per sextant. | 54 | Dentist | 359.40 |
| 8741 | Gingivectomy-gingivoplasty– per quadrant. | 54 | Dentist | 589.60 |
| 8743 | Gingivectomy-gingivoplasty per sextant. | 54 | Dentist | 471.20 |
| 8749 | Flap operation – per quadrant. | 54 | Dentist | 1,224.10 |
| 8751 | Flap operation – per sextant. | 54 | Dentist | 1,013.80 |
| 8753 | Flap procedure root planning and four or | 54 | Dentist | 1,517.20 |
| 8755 | Flap operation – more than three – per sextant. | 54 | Dentist | 1,229.70 |
| 8756 | Clinical crown lengthening | 54 | Dentist | 745.60 |
| 8759 | Pedicle flapped graft. | 54 | Dentist | 560.20 |
| 8761 | Masticatory mucosal autograft. | 54 | Dentist | 608.90 |
| 8762 | Masticatory mucosal autograft – more than 4 teeth. | 54 | Dentist | 914.70 |
| 8763 | Wedge resection. | 54 | Dentist | 358.20 |
| 8765 | Hemisection/Resection of a root/Tunnel preparation | 54 | Dentist | 492.30 |
| 8766 | Bone regenerative/repair – for flap operation. | 54 | Dentist | 293.00 |
| 8767 | Bone regenerative/repair procedure – single site. | 54 | Dentist | 759.60 |
| 8768 | Any other periodontal procedure – single tooth. | 54 | Dentist | 358.20 |
| 8769 | Subseq. removal of membrane – guided tissue regene. | 54 | Dentist | 358.20 |
| 8770 | Cost of bone regenerative/repair material. | 54 | Dentist | – |
| 8772 | Submucosal connective tissue autograft | 54 | Dentist | 615.30 |
| 8773 | Cost of intrapocket chemotherapeutic agent | 54 | Dentist | – |
| 8787 | Any other procedure connected with oral medicine. | 54 | Dentist | 128.60 |
| 8811 | Tracing and analysis of 8116. | 54 | Dentist | 34.50 |
| 8839 | Orthodontic diagnostic setup. | 54 | Dentist | 153.60 |
| 8840 | Treatment planning for orthognathic surgery. | 54 | Dentist | 528.70 |
| 8841 | Single arch treatment: Mild | 54 | Dentist | 8,176.00 |
| 8842 | Single arch treatment: Moderate. | 54 | Dentist | 9,608.50 |
| 8843 | Single arch treatment: Severe. | 54 | Dentist | 10,947.30 |
| 8846 | Retainers Removable: Repair | 54 | Dentist | 103.50 |
| 8847 | Retainers: Replacement. | 54 | Dentist | 358.20 |
| 8848 | Retainers: Fixed:Repair or replacement per unit. | 54 | Dentist | 153.60 |
| 8849 | Retainer | 54 | Dentist | 358.20 |
| 8850 | Treatment of Myofascial pain: lst Consultation. | 54 | Dentist | 172.70 |
| 8851 | Treatment of Myofascial pain: subseq. consulation. | 54 | Dentist | 91.10 |
| 8852 | Bite plate for TMJ dysfunction | 54 | Dentist | 433.90 |
| 8855 | Consultation-cleft palate therapy (house or hosp) | 54 | Dentist | 209.50 |
| 8856 | Consultation-cleft palate (subsequent) | 54 | Dentist | 102.90 |
| 8857 | Consultation-cleft palate (maximum) | 54 | Dentist | 715.40 |
| 8858 | Functional appliance | 54 | Dentist | 2,281.10 |
| 8861 | Minor corrective therapy: Fixed. | 54 | Dentist | 1,517.20 |
| 8862 | Minor corrective therapy:Removable (single). | 54 | Dentist | 1,266.40 |
| 8863 | Minor corrective therapy: Removable (per additional) | 54 | Dentist | 636.50 |
| 8865 | Maxillary or mandibular arch | 54 | Dentist | 4,047.00 |
| 8866 | Combined upper and lower arch | 54 | Dentist | 5,566.00 |
| 8867 | Single arch treatment: Mild | 54 | Dentist | 4,350.20 |
| 8868 | Single arch treatment: Moderate. | 54 | Dentist | 5,365.70 |
| 8869 | Single arch treatment: Severe. | 54 | Dentist | 6,276.00 |
| 8873 | Class I Malocclusions: Mild. | 54 | Dentist | 7,961.00 |
| 8874 | Class I Malocclusions: Mild | 54 | Dentist | 15,597.10 |
| 8875 | Class I Malocclusions: Moderate. | 54 | Dentist | 9,773.10 |
| 8876 | Class I Malocclusions: Moderate. | 54 | Dentist | 18,261.00 |
| 8877 | Class I Malocclusions: Severe. | 54 | Dentist | 11,392.80 |
| 8878 | Class I Malocclusions: Severe. | 54 | Dentist | 20,724.10 |
| 8879 | Class I Malocclusions: Severe with complications. | 54 | Dentist | 12,803.50 |
| 8880 | Class I Malocclusions: Severe plus complications | 54 | Dentist | 22,995.10 |
| 8881 | Class II & III Malocclusions: Mild. | 54 | Dentist | 11,392.80 |
| 8882 | Class II & III: Mild | 54 | Dentist | 19,037.00 |
| 8883 | Class II & III Malocclusions: Moderate. | 54 | Dentist | 12,803.50 |
| 8884 | Class II & III: Moderate. | 54 | Dentist | 21,296.20 |
| 8885 | Class II & III Malocclusions: Severe. | 54 | Dentist | 14,373.00 |
| 8886 | Class II & III: Severe. | 54 | Dentist | 23,718.80 |
| 8887 | Class II & III Malocclusions: Severe with complic. | 54 | Dentist | 16,193.90 |
| 8888 | Class II & III: Severe plus complications. | 54 | Dentist | 26,392.00 |
| 8890 | Orthodontic Treatment | 54 | Dentist | – |
| 8891 | Orthodontics: Deposit | 54 | Dentist | – |
| 8892 | Orthodontics: First Installment | 54 | Dentist | – |
| 8901 | MFO Surgeon: Consultation at consulting rooms. | 54 | Dentist | – |
| 8908 | Removal of roots from maxillary antrum (Caldwell-Luc | 54 | Dentist | 1,491.30 |
| 8909 | Closure of oral antral fistula – acute or chronic. | 54 | Dentist | 1,143.40 |
| 8911 | Caldwell-Luc procedure. | 54 | Dentist | 447.50 |
| 8917 | Biopsies: Intra-oral. | 54 | Dentist | 285.00 |
| 8919 | Biopsy of bone – needle biopsy. | 54 | Dentist | 438.80 |
| 8921 | Biopsy of bone: Open. | 54 | Dentist | 718.00 |
| 8931 | Local treatment of post-extraction haemorrhage. | 54 | Dentist | 82.70 |
| 8933 | Treatment of haemorrhage – blood dyscrasias – week. | 54 | Dentist | 1,143.40 |
| 8935 | Treatment of post-extraction septic socket. | 54 | Dentist | 82.70 |
| 8937 | Surgical removal of erupted tooth req.elevation of | 54 | Dentist | 487.90 |
| 8941 | Surgical removal of impacted tooth- first tooth | 54 | Dentist | 808.70 |
| 8943 | Surgical removal of imacted tooth- second tooth | 54 | Dentist | 433.90 |
| 8945 | Surgical removal of impacted tooth – third and | 54 | Dentist | 246.60 |
| 8957 | Alveolotomy or alveolectomy (per jaw). | 54 | Dentist | 598.80 |
| 8958 | Tracheostomy | 54 | Dentist | 503.20 |
| 8959 | Pharyngostomy | 54 | Dentist | 503.20 |
| 8961 | Auto-transplantation of teeth | 54 | Dentist | 981.70 |
| 8962 | Harvest iliac crest graft | 54 | Dentist | 362.00 |
| 8963 | Harvest rib graft | 54 | Dentist | 415.10 |
| 8964 | Harvest cranium graft | 54 | Dentist | 325.20 |
| 8965 | Peripheral neurectomy. | 54 | Dentist | 886.80 |
| 8966 | Functional repair of oronasal fistula (local flaps). | 54 | Dentist | 1,365.60 |
| 8967 | Cysts of jaws: Intra-oral approach. | 54 | Dentist | 1,363.80 |
| 8969 | Cysts of jaws: Extra-oral approach. | 54 | Dentist | 2,184.70 |
| 8971 | Surgical treatment of soft tissue tumours | 54 | Dentist | 438.80 |
| 8973 | Surgical treatment of tumours of the jaws. | 54 | Dentist | 2,184.70 |
| 8975 | Hemiresection of jaw with splintage of segments. | 54 | Dentist | 2,295.10 |
| 8977 | Major repairs of upper or lower jaw. | 54 | Dentist | 2,293.30 |
| 8979 | Harvesting of autogenous grafts (intra-oral) | 54 | Dentist | 189.00 |
| 8981 | Surgical exposure of impacted/unerupted teeth. | 54 | Dentist | 900.90 |
| 8983 | Corticotomy – first tooth. | 54 | Dentist | 651.90 |
| 8984 | Corticotomy – adjacent or subsequent tooth. | 54 | Dentist | 330.70 |
| 8985 | Frenectomy. | 54 | Dentist | 598.80 |
| 8987 | Reduction of mylohyoid ridges per side | 54 | Dentist | 981.70 |
| 8989 | Torus mandibularis reduction per side | 54 | Dentist | 981.70 |
| 8991 | Torus palatinus reduction | 54 | Dentist | 981.70 |
| 8993 | Reduction of hypertrophic tuberosity – per side. | 54 | Dentist | 438.80 |
| 8995 | Gingivectomy – per jaw. | 54 | Dentist | 873.30 |
| 8997 | Sulcoplasty/Vestibuloplasty. | 54 | Dentist | 2,250.90 |
| 9003 | Repositioning mental foramen and nerve – per side. | 54 | Dentist | 1,363.80 |
| 9004 | Lateralization if inferior denture nerve | 54 | Dentist | 2,197.70 |
| 9005 | Alveolar ridge augmentation by bone graft. | 54 | Dentist | 2,295.10 |
| 9007 | Alveolar ridge augmentation by alloplastic material. | 54 | Dentist | 1,444.60 |
| 9008 | Alveolar ridge augmentation across 1 to 2 adjacent t | 54 | Dentist | 446.50 |
| 9009 | Alveolar ridge augmentation across 3 or more tooth s | 54 | Dentist | 992.70 |
| 9010 | Sinus lift procedure/ Sinus lig prosedure | 54 | Dentist | 1,491.30 |
| 9011 | Incision and drainage of pyogenic abscesses. | 54 | Dentist | 279.30 |
| 9013 | Incision/Drainage pyogenic abscess – extra-oral. | 54 | Dentist | 381.80 |
| 9015 | Apicectomy including retrograde filling – anterior. | 54 | Dentist | 556.40 |
| 9016 | Apicectomy including retrograde filling – posterior. | 54 | Dentist | 981.70 |
| 9017 | Decortication/saucerisation/sequestromy – osteomye. | 54 | Dentist | 2,021.20 |
| 9019 | Sequestrectomy intra-oral per sextant and or ramus | 54 | Dentist | 438.80 |
| 9021 | Soft tissue injuries – minor. | 54 | Dentist | 556.40 |
| 9023 | Soft tissue injuries – major. | 54 | Dentist | 1,035.90 |
| 9024 | Dento-alveolar fracture per sextant | 54 | Dentist | 492.30 |
| 9025 | Treatment by closed reduction with inter. fixation. | 54 | Dentist | 1,090.10 |
| 9027 | Treatment of compound fracture – eyelet wiring. | 54 | Dentist | 1,531.10 |
| 9029 | Treatment of fracture by metal cap splintage. | 54 | Dentist | 1,695.00 |
| 9031 | Treatment of open reduction with rest. of occlusion. | 54 | Dentist | 2,512.50 |
| 9035 | Le Fort I or Guerin fracture./Cell Culture: | 54 | Dentist | 1,385.20 |
| 9037 | Le Fort II or middle third of face. | 54 | Dentist | 2,269.80 |
| 9039 | Le Fort III or craniofacial disjunction. | 54 | Dentist | 3,255.30 |
| 9041 | Zygomatic arch fracture – closed reduction | 54 | Dentist | 1,090.10 |
| 9043 | Unstable and/or comminuted zygoma. | 54 | Dentist | 2,184.70 |
| 9045 | Fracture requiring multiple interosseous wiring. | 54 | Dentist | 3,273.00 |
| 9046 | Placement of Zygomaticus fixture per fixture3 | 54 | Dentist | 2,161.90 |
| 9047 | Improvement of occlusal function – no reduction. | 54 | Dentist | 4,580.60 |
| 9048 | Removal of internal fixation devices per site | 54 | Dentist | 419.80 |
| 9049 | Osteotomy of mandible – no reduction./Directed | 54 | Dentist | 3,817.80 |
| 9050 | Total subapical osteotomy/Paternity investigation – | 54 | Dentist | 6,983.10 |
| 9051 | Genioplasty – no reduction. | 54 | Dentist | 2,184.70 |
| 9052 | Midfacial exposure – no reduction. | 54 | Dentist | 3,458.50 |
| 9053 | Coronoidectomy (intra-oral approach). | 54 | Dentist | 1,362.80 |
| 9055 | Osteotomy (Schukardt) – no reduction. | 54 | Dentist | 3,817.80 |
| 9057 | Osteotomy (Wassmund) – no reduction. | 54 | Dentist | 3,817.80 |
| 9059 | Le Fort I-osteotomy – no reduction. | 54 | Dentist | 7,183.40 |
| 9060 | Le Fort I osteotomy with repositioning – no reduc. | 54 | Dentist | 8,063.80 |
| 9061 | Palatal osteotomy – no reduction. | 54 | Dentist | 2,512.50 |
| 9062 | Le Fort I osteotomy – multiple segments – No reduct. | 54 | Dentist | 9,169.60 |
| 9063 | Le Fort II osteotomy – facial deformities – no red. | 54 | Dentist | 9,174.20 |
| 9065 | Le Fort III osteotomy – congenital deformities. | 54 | Dentist | 13,749.40 |
| 9066 | Surgically assisted maxillary or mandibular expan- | 54 | Dentist | 2,184.70 |
| 9069 | Functional tongue reduction – No reduction. | 54 | Dentist | 1,636.30 |
| 9071 | Geniohyoidotomy – no reduction. | 54 | Dentist | 981.70 |
| 9072 | Funct. closure of secondary oro-nasal fistula. | 54 | Dentist | 7,183.40 |
| 9074 | Diagnostic arthroscopy. | 54 | Dentist | 1,084.60 |
| 9075 | Condylectomy or coronoidectomy or both/menisectomy. | 54 | Dentist | 2,724.70 |
| 9076 | Arthrocentesis TMJ | 54 | Dentist | 598.80 |
| 9077 | Intra-articular injection – per injection. | 54 | Dentist | 163.30 |
| 9079 | Trigger point injection: per injection. | 54 | Dentist | 127.40 |
| 9081 | Condyle neck osteotomy (Ward/Kostecka). | 54 | Dentist | 1,090.10 |
| 9083 | Temperomand artroplasty (le Clerk/Toller procedure). | 54 | Dentist | 2,724.70 |
| 9085 | Reduction temporomandibular joint – no anaesth. | 54 | Dentist | 216.90 |
| 9087 | Reduction temporomandibular joint – with aneast. | 54 | Dentist | 438.80 |
| 9089 | Red. temporomandibular joint with anaest/immobil. | 54 | Dentist | 1,090.10 |
| 9091 | Red. temporomandibular joint dis.- open reduction. | 54 | Dentist | 2,724.70 |
| 9092 | Total joint reconstruction – alloplastic or bone. | 54 | Dentist | 7,274.10 |
| 9093 | Removal of salivary calculus. | 54 | Dentist | 492.30 |
| 9095 | Removal of salivary gland. | 54 | Dentist | 1,213.20 |
| 9096 | Removal of salivary Gland | 54 | Dentist | 1,797.20 |
| 9101 | Surgical obturator – Modified denture. | 54 | Dentist | 150.60 |
| 9102 | Surgical obturator – continuous base. | 54 | Dentist | 408.50 |
| 9103 | Surgical obturator – split base. | 54 | Dentist | 608.90 |
| 9104 | Interim obturator on existing denture. | 54 | Dentist | 918.30 |
| 9105 | Interim obturator on new denture. | 54 | Dentist | 2,835.80 |
| 9106 | Definitive obturator – open. | 54 | Dentist | 918.30 |
| 9107 | Definitive obturator – silicone glove. | 54 | Dentist | 1,773.30 |
| 9108 | Mandib. resection prosthesis with guide flange. | 54 | Dentist | 2,178.20 |
| 9109 | Mandib. resection prosthesis without guide flange. | 54 | Dentist | 2,023.90 |
| 9110 | Mandib. resection prosthesis – Palatal augmentation. | 54 | Dentist | 408.50 |
| 9111 | Glossal resection prosthesis – simple prosthesis. | 54 | Dentist | 852.10 |
| 9112 | Glossal resection prosthesis – complex prosthesis. | 54 | Dentist | 1,276.60 |
| 9113 | Radiotherapy appliances: Carriers – simple. | 54 | Dentist | 918.30 |
| 9114 | Radiotherapy appliances: Carriers – complex. | 54 | Dentist | 2,534.60 |
| 9115 | Radiotherapy appliances: Shields – simple. | 54 | Dentist | 918.30 |
| 9116 | Radiotherapy appliances: Shields – complex. | 54 | Dentist | 2,534.60 |
| 9117 | Radiotherapy appliances: Cone locators. | 54 | Dentist | 918.30 |
| 9118 | Chemotherapeutic agent carriers. | 54 | Dentist | 918.30 |
| 9119 | Passive presurgical prosthesis. | 54 | Dentist | 812.70 |
| 9120 | Active presurgical orthopaedic appliance – minor. | 54 | Dentist | 812.70 |
| 9121 | Active presurgical orthopaedic appliance – moderate. | 54 | Dentist | 1,202.90 |
| 9122 | Active presurgical orthopaedic appliance – severe. | 54 | Dentist | 2,023.90 |
| 9123 | Active presurgical orthopaedic appiance adjustment. | 54 | Dentist | 102.90 |
| 9125 | Speech aid/obturator with palatal modification. | 54 | Dentist | 409.60 |
| 9126 | Speech aid/obturator with velar modification. | 54 | Dentist | 918.30 |
| 9127 | Speech aid/obturator with pharyngeal modification. | 54 | Dentist | 2,023.90 |
| 9128 | Speech aid/obturator adjustment. | 54 | Dentist | 102.90 |
| 9129 | Speech aid/obturator surgical prosthesis. | 54 | Dentist | 812.70 |
| 9130 | Speech appliances: Palatal lift. | 54 | Dentist | 408.50 |
| 9131 | Speech appliances: Palatal stimulating. | 54 | Dentist | 918.30 |
| 9132 | Speech appliances: Speech bulb. | 54 | Dentist | 2,023.90 |
| 9133 | Speech appliances: Adjustments. | 54 | Dentist | 102.90 |
| 9134 | Speech appliances (Other) – by arrangement. | 54 | Dentist | – |
| 9135 | Auricular prosthesis – simple. | 54 | Dentist | 2,534.60 |
| 9136 | Auricular prosthesis – complex. | 54 | Dentist | 3,307.00 |
| 9137 | Nasal prosthesis – simple./Bone Marrow Donar Typing | 54 | Dentist | 2,534.60 |
| 9138 | Nasal prosthesis – complex. | 54 | Dentist | 3,307.00 |
| 9139 | Ocular prosthesis – conformer. | 54 | Dentist | 918.30 |
| 9140 | Ocular prosthesis using modified stock appliance. | 54 | Dentist | 2,278.50 |
| 9141 | Ocular prosthesis using custom appliance. | 54 | Dentist | 3,307.00 |
| 9142 | Orbital prosthesis – simple (excl. ocular section). | 54 | Dentist | 2,278.50 |
| 9143 | Orbital prosthesis – complex (excl. ocular section). | 54 | Dentist | 3,307.00 |
| 9148 | Other body prostheses – simple. | 54 | Dentist | 2,278.50 |
| 9149 | Other body prostheses – complex./Chorionic Villus | 54 | Dentist | 3,307.00 |
| 9150 | Surgical facial prostheses – simple. | 54 | Dentist | 1,773.30 |
| 9151 | Surgical facial prostheses – complex. | 54 | Dentist | 2,278.50 |
| 9155 | Cranial prosthesis. | 54 | Dentist | 918.30 |
| 9156 | Custom implants: Cranial – acrylic/elast/metallic. | 54 | Dentist | 1,108.50 |
| 9157 | Implants: Facial – simple. | 54 | Dentist | 553.90 |
| 9158 | Implants: Facial – complex./Blood: DNA extraction | 54 | Dentist | 1,108.50 |
| 9159 | Implants: Ocular – custom made./HLA low res.Class II | 54 | Dentist | 553.90 |
| 9160 | Implants: Body – special prosthesis. | 54 | Dentist | 2,464.80 |
| 9161 | Appliances: Splints – simple. | 54 | Dentist | 250.60 |
| 9162 | Appliances: Splints – complex./Karyotyping products | 54 | Dentist | 918.30 |
| 9163 | Appliances: Templates – simple./Cell culture product | 54 | Dentist | 250.60 |
| 9164 | Appliances: Templates – complex./Additional analysis | 54 | Dentist | 918.30 |
| 9165 | Appliances: Conformers – simple. | 54 | Dentist | 250.60 |
| 9166 | Appliances: Conformers – complex. | 54 | Dentist | 918.30 |
| 9167 | Trismus appliance – simple. | 54 | Dentist | 102.90 |
| 9168 | Trismus appliance – complex. | 54 | Dentist | 918.30 |
| 9169 | Orthoses (for paralysed patients). | 54 | Dentist | 2,023.90 |
| 9170 | Facial palsy appliances. | 54 | Dentist | 608.90 |
| 9171 | Oral splints (per commissure). | 54 | Dentist | 250.60 |
| 9172 | Dynamic oral retractors (per arm). | 54 | Dentist | 250.60 |
| 9174 | Burn appliances: Other. | 54 | Dentist | – |
| 9175 | Attendance in theatre – per hour. | 54 | Dentist | 338.80 |
| 9180 | Placement of sub-periosteal implant – do NOT reduce. | 54 | Dentist | 1,485.80 |
| 9181 | Placement of sub-perio. implant pros. – no reduction | 54 | Dentist | 1,485.80 |
| 9182 | Placem. of endosteal implant – per implant. | 54 | Dentist | 743.80 |
| 9183 | Placem. of single osseointegrated implant per jaw. | 54 | Dentist | 1,046.90 |
| 9184 | Placem. 2nd osseointegrated implant in same jaw. | 54 | Dentist | 784.00 |
| 9185 | Placem. 3rd & subseq. osseointegrated implant. | 54 | Dentist | 524.70 |
| 9187 | Cost of endosteal implant body | 54 | Dentist | – |
| 9188 | Cost of prefabricated abutment | 54 | Dentist | – |
| 9189 | Cost of implants. | 54 | Dentist | – |
| 9190 | Exposure of single osseointegrated implant. | 54 | Dentist | 388.40 |
| 9191 | Expos. of 2nd osseointegrated implant – same jaw. | 54 | Dentist | 291.90 |
| 9192 | Expos. of 3rd & subseq. osseoint. implant. | 54 | Dentist | 195.60 |
| 9198 | Implant removal | 54 | Dentist | 484.00 |
| 9220 | Repair of cleft hard palate (uniateral). | 54 | Dentist | 4,012.10 |
| 9222 | Repair of cleft hard palate (bilateral – one | 54 | Dentist | 5,093.00 |
| 9224 | Repair of cleft hard palate (bilateral in two | 54 | Dentist | 7,589.30 |
| 9226 | Repair of cleft soft palate (without muscle | 54 | Dentist | 3,361.90 |
| 9228 | Repair of soft palatum (with muscle reconstruc- | 54 | Dentist | 4,881.70 |
| 9230 | Repair of submucosal cleft and/or bifid uvula | 54 | Dentist | 3,634.60 |
| 9232 | Velopharyngeal reconstruction (uncomplicated). | 54 | Dentist | 3,740.30 |
| 9234 | Velopharyngeal reconstruction (complicated type). | 54 | Dentist | 3,999.50 |
| 9238 | Functional repair of oro-nasal fistula (distant | 54 | Dentist | 2,287.80 |
| 9240 | Functional repair of oro-nasal fistula – 2 proced. | 54 | Dentist | 3,991.00 |
| 9246 | Secondary periost. swivel flaps for bone induction. | 54 | Dentist | 1,994.40 |
| 9248 | Lipadhesion | 54 | Dentist | 745.60 |
| 9250 | Unilateral cleft lip repair (without muscle recon.) | 54 | Dentist | 1,313.10 |
| 9252 | Unilateral cleft lip repair (with muscle reconstruc. | 54 | Dentist | 1,780.60 |
| 9254 | Bilateral cleft lip repair (without muscle reconstr) | 54 | Dentist | 1,833.80 |
| 9256 | Bilateral cleft lip repair (with muscle reconstruc.) | 54 | Dentist | 2,833.20 |
| 9258 | Anterior nasal floor repair (between alveolus) | 54 | Dentist | 715.40 |
| 9260 | Partial revision of secondary cleft lip deformity | 54 | Dentist | 715.40 |
| 9262 | Total revision of secondary cleft lip deformity | 54 | Dentist | 1,616.30 |
| 9264 | Abbe-flap (in two stages) | 54 | Dentist | 1,830.30 |
| 9266 | Columella reconstruction | 54 | Dentist | 1,081.90 |
| 9268 | Partial reconstruction of nose due to cleft deform. | 54 | Dentist | 1,374.80 |
| 9270 | Complete reconstruction of nose due to cleft deform. | 54 | Dentist | 2,172.80 |
| 9272 | Paranasal augmentation for nasal base deviation | 54 | Dentist | 1,081.90 |
| 9301 | Casting of model in plaster per model | 54 | Dentist | 32.10 |
| 9303 | Casting of model in superhard stone per model | 54 | Dentist | 45.70 |
| 9305 | Casting and trimming of study model per model / | 54 | Dentist | 84.60 |
| 9307 | Casting and trimming of gnathostatic study model | 54 | Dentist | 110.00 |
| 9309 | New trimmed base to supplied model per model | 54 | Dentist | 38.80 |
| 9311 | Trimming of supplied model per model | 54 | Dentist | 23.70 |
| 9312 | Gingival tissue mask per impression (incl material | 54 | Dentist | 183.00 |
| 9313 | Duplicating model per model | 54 | Dentist | 98.40 |
| 9314 | Refractory model per unit | 54 | Dentist | 96.60 |
| 9315 | Models and dup models for crown & bridge work | 54 | Dentist | 133.80 |
| 9317 | Sectional models for crown & bridge work inclusive | 54 | Dentist | 118.50 |
| 9319 | Each additional die for items 9315 & 9317 per die | 54 | Dentist | 30.50 |
| 9320 | Pindex or indexed model tray per die | 54 | Dentist | 30.50 |
| 9321 | Occlusion block per block | 54 | Dentist | 116.70 |
| 9323 | Occlusion block on baseplate per block | 54 | Dentist | 147.30 |
| 9327 | Infection control per impression in imp. material | 54 | Dentist | 22.00 |
| 9329 | Fit & supply of disposable articulator | 54 | Dentist | 57.60 |
| 9330 | Delivery charge per completed procedure | 54 | Dentist | 61.00 |
| 9331 | Full upper and lower dentrures. | 54 | Dentist | 1,570.70 |
| 9333 | Full upper or lower denture. | 54 | Dentist | 919.10 |
| 9335 | Set up and waxing of full upper and lower dentures. | 54 | Dentist | 541.60 |
| 9337 | Set up and waxing of full upper or lower dentures. | 54 | Dentist | 362.20 |
| 9339 | Waxing and finishing of full upper & lower dentures. | 54 | Dentist | 963.20 |
| 9341 | Waxing and finising of full upper or lower denture. | 54 | Dentist | 538.20 |
| 9343 | Additional fee for dentures on adj. articulator. | 54 | Dentist | 1,533.40 |
| 9345 | Additional fee for immediate dentures – per tooth | 54 | Dentist | 22.00 |
| 9346 | Additional fee for immediate dentures – not socketed | 54 | Dentist | 11.80 |
| 9347 | Additional fee for each retry form the third retry | 54 | Dentist | 348.60 |
| 9351 | Set-up and finish one-tooth denture | 54 | Dentist | 421.50 |
| 9352 | Set-up and finish two-tooth denture | 54 | Dentist | 448.60 |
| 9353 | Set-up and finish three-tooth denture | 54 | Dentist | 480.70 |
| 9354 | Set-up and finish four-tooth denture | 54 | Dentist | 507.80 |
| 9355 | Set-up and finish five-tooth denture | 54 | Dentist | 548.40 |
| 9356 | Set-up and finish six-tooth denture | 54 | Dentist | 655.10 |
| 9357 | Set-up and finish seven-tooth denture | 54 | Dentist | 778.60 |
| 9358 | Set-up and finish eight-tooth denture | 54 | Dentist | 826.20 |
| 9359 | Set-up and finish nine-tooth denture | 54 | Dentist | 846.40 |
| 9361 | Set-up and waxing of one-tooth denture | 54 | Dentist | 120.10 |
| 9362 | Set-up and waxing of two-tooth denture | 54 | Dentist | 145.50 |
| 9363 | Set-up and waxing of three-tooth denture | 54 | Dentist | 165.80 |
| 9364 | Set-up and waxing of four-tooth denture | 54 | Dentist | 192.90 |
| 9365 | Set-up and waxing of five-tooth denture | 54 | Dentist | 213.30 |
| 9366 | Set-up and waxing of six-tooth denture | 54 | Dentist | 252.20 |
| 9367 | Set-up and waxing of seven-tooth denture | 54 | Dentist | 277.50 |
| 9368 | Set-up and waxing of eight-tooth denture | 54 | Dentist | 297.90 |
| 9369 | Set-up and waxing of nine-tooth denture | 54 | Dentist | 318.10 |
| 9371 | Waxing and finishing of one-tooth denture | 54 | Dentist | 330.00 |
| 9372 | Waxing and finishing of two-tooth denture | 54 | Dentist | 336.80 |
| 9373 | Waxing and finishing of three-tooth denture | 54 | Dentist | 342.10 |
| 9374 | Waxing and finising of four-tooth denture | 54 | Dentist | 348.60 |
| 9375 | Waxing and finishing of five-tooth denture | 54 | Dentist | 362.20 |
| 9376 | Waxing and finishing of six-tooth denture | 54 | Dentist | 375.90 |
| 9377 | Waxing and finising of seven-tooth denture | 54 | Dentist | 468.80 |
| 9378 | Set-up and finishing of eight-tooth denture | 54 | Dentist | 487.50 |
| 9379 | Set-up and finishing of nine-tooth denture | 54 | Dentist | 514.60 |
| 9380 | Set-up and finishing of ten (or more) tooth denture | 54 | Dentist | – |
| 9383 | Additional fee for finishing off in tooth colour or | 54 | Dentist | 81.10 |
| 9385 | Additional fee for supplying finished denture on | 54 | Dentist | 154.10 |
| 9391 | Basic charge which includes repair of one fracture | 54 | Dentist | 267.30 |
| 9393 | Additional charge for each additional fracture or | 54 | Dentist | 82.90 |
| 9395 | Additional fee for using wire strengthener | 54 | Dentist | 94.80 |
| 9397 | Additional fee for using pre-formed strengthener | 54 | Dentist | 101.40 |
| 9398 | Additional fee for using any other mesh strengthener | 54 | Dentist | 160.80 |
| 9401 | Clear palate | 54 | Dentist | 118.50 |
| 9403 | Dox grinding of upper and lower dentures | 54 | Dentist | 150.50 |
| 9405 | Inlay to artificial tooth one surface only per inlay | 54 | Dentist | 259.10 |
| 9406 | Inlay to artificial tooth multi-surfaces eg | 54 | Dentist | 331.80 |
| 9407 | Heka base technique per upper or lower denture | 54 | Dentist | 355.50 |
| 9409 | Frego frame (excluding cost of material) | 54 | Dentist | 154.10 |
| 9410 | Bl tray (Excluding cost of material) | 54 | Dentist | 170.90 |
| 9411 | Template per upper or lower denture | 54 | Dentist | 424.80 |
| 9413 | Reline of single denture | 54 | Dentist | 535.00 |
| 9415 | Remodel of single denture | 54 | Dentist | 822.60 |
| 9417 | Soft base reline per denture excluding soft base | 54 | Dentist | 1,350.80 |
| 9419 | Soft base to new denture per denture excluding soft | 54 | Dentist | 1,350.80 |
| 9421 | Gum tinting per denture | 54 | Dentist | 250.60 |
| 9423 | Lingual or palatal bar (excluding cost of material) | 54 | Dentist | 201.40 |
| 9425 | Cleaning & polishing of existing denture per denture | 54 | Dentist | 164.20 |
| 9427 | Mesh strengthener (excluding cost of material) | 54 | Dentist | 140.50 |
| 9429 | Theatre/Consutation out of laboratory per hour or | 54 | Dentist | 348.60 |
| 9431 | Special tray acrylic each | 54 | Dentist | 132.10 |
| 9432 | Special Tray Light cure (including material) | 54 | Dentist | 143.80 |
| 9433 | Special tray in base plate material each | 54 | Dentist | 135.40 |
| 9435 | Provision of single arm clasp to partial denture | 54 | Dentist | 69.40 |
| 9437 | Provision of double arm clasp to partial denture | 54 | Dentist | 120.10 |
| 9439 | Provision of single arm clasp with rest to partial | 54 | Dentist | 155.70 |
| 9441 | Provision of double arm clasp with rest to partial | 54 | Dentist | 209.90 |
| 9443 | Provision of preformed clasps or Roachball clasp to | 54 | Dentist | 89.70 |
| 9445 | Provision of rest only to partial denture | 54 | Dentist | 89.70 |
| 9447 | Provision of cast clasp to partial denture | 54 | Dentist | 314.70 |
| 9448 | Model of impression inside occlusion block or wax | 54 | Dentist | 57.60 |
| 9450 | 15% Surcharge on acrylic work finished to a chrome | 54 | Dentist | 120.10 |
| 9451 | Metal base for full upper or full lower denture each | 54 | Dentist | 1,078.20 |
| 9453 | Basic charge excluding models & any special trays | 54 | Dentist | 942.80 |
| 9455 | Additional charge for each one arm clasp | 54 | Dentist | 38.80 |
| 9457 | Additional charge for each Roach clasp | 54 | Dentist | 65.90 |
| 9459 | Additional charge for each rest | 54 | Dentist | 35.50 |
| 9461 | Additional charge for continuous clasp per tooth | 54 | Dentist | 38.80 |
| 9463 | Additional charge for lingual bar per tooth passed | 54 | Dentist | 91.50 |
| 9465 | Additional charge for palatal bar | 54 | Dentist | 145.50 |
| 9467 | Additional charge for onlay | 54 | Dentist | 387.60 |
| 9469 | Additional charge for saddle with finishing line | 54 | Dentist | 64.20 |
| 9471 | Additional charge for saddle without finishing line | 54 | Dentist | 37.30 |
| 9473 | Additional charge for horseshoe saddle per tooth | 54 | Dentist | 64.20 |
| 9475 | Additional charge for fitting of tooth for metal | 54 | Dentist | 44.10 |
| 9477 | Additional charge for goldplating per denture | 54 | Dentist | – |
| 9479 | Additional charge for fitting one distal-extension | 54 | Dentist | 130.40 |
| 9480 | Additional charge per milled edge per tooth | 54 | Dentist | 113.60 |
| 9481 | Additional charge for each soldering joint | 54 | Dentist | 159.10 |
| 9483 | Additional charge for soldering retention | 54 | Dentist | 192.90 |
| 9485 | Add. charge for each add. retention soldering joint | 54 | Dentist | 59.10 |
| 9487 | Additional charge for each welding joint | 54 | Dentist | 194.70 |
| 9489 | Additional charge for fitting swing lock incl cost | 54 | Dentist | 159.10 |
| 9491 | Additional charge for each backing cost | 54 | Dentist | 155.70 |
| 9493 | Add. charge for each Steel’s backing or ponting | 54 | Dentist | 169.30 |
| 9495 | Dental Technicians Fees | 54 | Dentist | 245.50 |
| 9497 | Dental Technicians Fees | 54 | Dentist | 279.30 |
| 9501 | Ceramic jacket crown | 54 | Dentist | 1,071.30 |
| 9502 | Ceramic metal substitute coping(incl material) | 54 | Dentist | 865.00 |
| 9505 | Porcelian veneer crown – non-precious metal | 54 | Dentist | 1,415.20 |
| 9507 | Additional charge for each soldering joint | 54 | Dentist | 289.50 |
| 9511 | Inlay in porcelain veneer crown | 54 | Dentist | 467.00 |
| 9512 | Ceramic Veneer/Bridge retainer | 54 | Dentist | 1,098.60 |
| 9515 | Porcelain shoulder per unit (not applicable to | 54 | Dentist | 94.80 |
| 9520 | Additional fee for crown & bridge work performed | 54 | Dentist | 45.70 |
| 9521 | Full metal crown | 54 | Dentist | 875.10 |
| 9524 | Indirect composite resin inlay | 54 | Dentist | 237.00 |
| 9525 | Class IV MO or DO cast indirect | 54 | Dentist | 721.10 |
| 9526 | Add. fee for one piece casting of crown or inlay | 54 | Dentist | 220.20 |
| 9531 | Pin-edge inlay | 54 | Dentist | 817.60 |
| 9533 | Occlusal surface pontic | 54 | Dentist | 646.60 |
| 9535 | Copint cast | 54 | Dentist | 606.00 |
| 9537 | Precision lock and rest cast incorp. pre-formed part | 54 | Dentist | 859.90 |
| 9538 | Lock and rest cast | 54 | Dentist | 411.40 |
| 9539 | Casting of rest only | 54 | Dentist | 245.50 |
| 9541 | Gold inlay or post cast direct | 54 | Dentist | 260.70 |
| 9543 | Gold soldering joint where investing is required | 54 | Dentist | 259.10 |
| 9545 | Cast post with thimble indirect | 54 | Dentist | 431.50 |
| 9546 | Dental Technicians Fees | 54 | Dentist | 714.30 |
| 9547 | Pontic or abutment thimble/Manufacture cast post and | 54 | Dentist | 563.70 |
| 9549 | CSP attachment (Steiger) | 54 | Dentist | 1,902.50 |
| 9550 | Milling milled edge per unit | 54 | Dentist | 606.00 |
| 9551 | Telescope crown | 54 | Dentist | 1,492.80 |
| 9553 | Acrylic veneer crown – indirect | 54 | Dentist | 1,193.20 |
| 9557 | Acrylic jacket crown – indirect | 54 | Dentist | 842.90 |
| 9559 | Acrylic veneer post crown | 54 | Dentist | 1,179.70 |
| 9560 | Indirect composite resin veneer | 54 | Dentist | 499.40 |
| 9561 | Acrylic jacket crown – direct | 54 | Dentist | 575.50 |
| 9562 | Silicoating (per unit) | 54 | Dentist | – |
| 9563 | Temporary acrylic crown cold cured per tooth/pontic | 54 | Dentist | 411.40 |
| 9564 | Heat formed template supplied to dentist for the | 54 | Dentist | 206.40 |
| 9565 | Acrylic-facing replaced | 54 | Dentist | 479.10 |
| 9566 | Porcelian facing replaced | 54 | Dentist | 868.40 |
| 9569 | Waxing of crown to existing denture | 54 | Dentist | 338.50 |
| 9570 | Add. fee for each remake at an agreed quantum | 54 | Dentist | 348.60 |
| 9571 | Basic charge which incl. acrylic base & excl. models | 54 | Dentist | 428.30 |
| 9572 | Basic charge for appliance which do not incl acrylic | 54 | Dentist | 206.40 |
| 9573 | Add. charge for fitting 1st expansion screw | 54 | Dentist | 81.10 |
| 9575 | Add. fee for fitting subsequent expansion screws | 54 | Dentist | 69.40 |
| 9576 | Additional fee for full aclusal bite plate | 54 | Dentist | 240.40 |
| 9577 | Additional fee for bite plate | 54 | Dentist | 81.10 |
| 9578 | Additional fee for bite plate posterior | 54 | Dentist | 81.10 |
| 9579 | Additional fee for fitting tongue guard | 54 | Dentist | 101.40 |
| 9581 | Additional fee for flat or inclined plane | 54 | Dentist | 62.60 |
| 9583 | Additional fee for Adams Crib | 54 | Dentist | 74.40 |
| 9585 | Additional fee for Jackson Crib | 54 | Dentist | 77.90 |
| 9587 | Additional fee for ball clasp | 54 | Dentist | 88.10 |
| 9589 | Additional fee for single arm clasp | 54 | Dentist | 67.70 |
| 9591 | Additional fee for double arm clasp | 54 | Dentist | 118.50 |
| 9593 | Additional fee for fitting single loop finger spring | 54 | Dentist | 55.80 |
| 9595 | Additional fee for fitting double loop finger spring | 54 | Dentist | 65.90 |
| 9597 | Additional fee for fitting buccal retraction spring | 54 | Dentist | 49.10 |
| 9599 | Additional fee for fitting apron spring | 54 | Dentist | 127.00 |
| 9603 | Additional fee for fitting coffin spring | 54 | Dentist | 121.80 |
| 9605 | Additional fee for fitting helicol or bakooka spring | 54 | Dentist | 135.40 |
| 9607 | Additional fee for fitting flapper or “T” spring | 54 | Dentist | 101.40 |
| 9609 | Add. fee for fitting all springs with tubing each | 54 | Dentist | 113.60 |
| 9611 | Additional fee for fitting labial arch | 54 | Dentist | 64.20 |
| 9613 | Additional fee for fitting buccal arch | 54 | Dentist | 76.20 |
| 9615 | Additional fee for fitting Roberts retractor | 54 | Dentist | 142.00 |
| 9617 | Invisible Retainer | 54 | Dentist | 187.80 |
| 9619 | Additional fee for fitting twinwire arch | 54 | Dentist | 177.80 |
| 9620 | Additional fee Lip bumper | 54 | Dentist | 74.40 |
| 9621 | Additional fee for fitting extra-oral arch | 54 | Dentist | 169.30 |
| 9622 | Additional fee for fitting space maintaner arch | 54 | Dentist | 74.40 |
| 9623 | Additional fee for each spot-welded joint. | 54 | Dentist | 33.70 |
| 9625 | Additional fee for each soldering joint. | 54 | Dentist | 54.20 |
| 9627 | Additional fee for each invested soldering joint. | 54 | Dentist | 150.50 |
| 9629 | Additional fee for each hook for elastic traction. | 54 | Dentist | 49.10 |
| 9631 | Mouth protector. | 54 | Dentist | 318.10 |
| 9633 | Oral screen. | 54 | Dentist | 390.90 |
| 9635 | Andersen of Noorwegian appliance. | 54 | Dentist | 699.20 |
| 9637 | Tooth positioner. | 54 | Dentist | 805.80 |
| 9639 | Gunning splint (excluding cost of material). | 54 | Dentist | 1,073.10 |
| 9641 | Frankel appliance | 54 | Dentist | 1,035.80 |
| 9643 | Chin cap | 54 | Dentist | 343.40 |
| 9645 | Bionator | 54 | Dentist | 700.90 |
| 9646 | Diagnostic set-up | 54 | Dentist | 673.80 |
| 9647 | Snoring Appliance | 54 | Dentist | 636.50 |
| 9651 | Pinched or swaged bank with welded attachment | 54 | Dentist | 206.40 |
| 9653 | Pinched or swaged band with soldered attachment | 54 | Dentist | 270.90 |
| 9662 | Additional fee for each remake at an agreed quantum | 54 | Dentist | 348.60 |
| 9700 | Diatorics 1 x 6/8 | 54 | Dentist | – |
| 9702 | Diatorics – odds- anterior | 54 | Dentist | – |
| 9704 | Diatorics- odds- posterior | 54 | Dentist | – |
| 9706 | Cost of Bleaching Tray material | 54 | Dentist | – |
| 9720 | Soft base material per denture | 54 | Dentist | – |
| 9722 | High impact acrylic per denture | 54 | Dentist | – |
| 9724 | Cost of Precision attachment.Per attachment. | 54 | Dentist | – |
| 9726 | Preformed Ball or roach clasp | 54 | Dentist | – |
| 9728 | Cost of lingual I palatal bar. | 54 | Dentist | – |
| 9729 | Cost of mesh stengthener | 54 | Dentist | – |
| 9730 | Cost of pre-fabricated burn-out component- per compo | 54 | Dentist | – |
| 9732 | Cost of other attachment components e.g. nylon caps- | 54 | Dentist | – |
| 9734 | Cost of dolder bar and clips- per gram or per clip – | 54 | Dentist | – |
| 9736 | Cost of implant components s- per gram or per clip – | 54 | Dentist | – |
| 9738 | Cost of preformed strengthener er gram or per clip – | 54 | Dentist | – |
| 9739 | Additional charge goldplating | 54 | Dentist | – |
| 9740 | Cost of gold wire- per gram er er gram or per clip – | 54 | Dentist | – |
| 9741 | Cost of Cobalt Chrome casting alloy am or per clip – | 54 | Dentist | – |
| 9742 | Cost of specialised Cobalt Chrome casting metal- e.g | 54 | Dentist | – |
| 9744 | Cost of precious casting alloy me casting metal- e.g | 54 | Dentist | – |
| 9746 | Cost of semi-precious casting alloy sting metal- e.g | 54 | Dentist | – |
| 9748 | Cost of non-precious casting alloy sting metal- e.g | 54 | Dentist | – |
| 9752 | Cost of platinum foil asting alloy sting metal- e.g | 54 | Dentist | – |
| 9754 | Cost of gold solder- per gram lloy sting metal- e.g | 54 | Dentist | – |
| 9755 | Etching for bonding (metal or ceramic) | 54 | Dentist | – |
| 9756 | Cost of silver solder- per gram oy sting metal- e.g | 54 | Dentist | – |
| 9757 | Ceromer material – per unit | 54 | Dentist | – |
| 9758 | Fiber re-enforced materual (per unit) | 54 | Dentist | – |
| 9759 | Fiber re-enforced bridge material (per unit) | 54 | Dentist | – |
| 9760 | Composite restoration material oy sting metal- e.g | 54 | Dentist | – |
| 9761 | Ceramic material | 54 | Dentist | – |
| 9762 | Cost of anterior orthodontic attachment – per attach | 54 | Dentist | – |
| 9763 | Orthodontic Material | 54 | Dentist | – |
| 9764 | Cost of posterior orthodontic attachment- per attach | 54 | Dentist | – |
| 9765 | Preformed Components | 54 | Dentist | – |
| 9766 | Cost of expansion screw- per screw hment- per attach | 54 | Dentist | – |
| 9767 | Soldering Material | 54 | Dentist | – |
| 9768 | Cost of buccle tube- per tube crew hment- per attach | 54 | Dentist | – |
| 9770 | Cost of J-hook- per hook tube crew hment- per attach | 54 | Dentist | – |
| 9772 | Cost of lingual buttons- per button ment- per attach | 54 | Dentist | – |
| 9774 | Cost of Invisible retainer material ment- per attach | 54 | Dentist | – |
| 9775 | R/A Case – Orthodontic Services | 54 | Dentist | – |
| 9776 | Cost of mouth protector material al ment- per attach | 54 | Dentist | – |
| 9778 | Cost of TMA arch wire r material al ment- per attach | 54 | Dentist | – |
| 9779 | Durasoft Material | 54 | Dentist | – |
| 9780 | Positioning and finishing of complete (male and fema | 54 | Dentist | 533.20 |
| 9782 | Positioning and soldering of complete ( male and fem | 54 | Dentist | 445.20 |
| 9783 | Implant stent per unit | 54 | Dentist | 411.40 |
| 9784 | Allignment of dolder bar and clips te ( male and fem | 54 | Dentist | 562.00 |
| 9786 | Waxing and finishing of implant abutment – crown and | 54 | Dentist | 241.90 |
| 9787 | Waxing milling and finishing of custom abutment | 54 | Dentist | 472.10 |
| 9788 | Implant superstructure incl. Placing of preformed pa | 54 | Dentist | 2,581.20 |
| 9789 | Finishing of prosthesis on implant structure | 54 | Dentist | 942.80 |
| 10001 | Used to combine services in order to reject/Whole | 54 | Dentist | – |
| 10004 | Risk Pool Benefit/Whole Blood – Reagent | 54 | Dentist | – |
| 11111 | Nil Benefit Tariff Code | 54 | Dentist | – |
| 77798 | FOREIGN SERVICES: SAVINGS | 54 | Dentist | – |
| 80008 | Memoriseerkode-tandheelkunde-15%van gelde vir asst. | 54 | Dentist | – |
| 90222 | 2005 Diamond / Discovery:Savings Advance claim | 54 | Dentist | – |
| 96805 | Polmed Exgratia co payment | 54 | Dentist | – |
| 98100 | Dental Missed Appointment | 54 | Dentist | – |
| 99099 | SAFETY-NET AUTHORISED/EX-GRATIA | 54 | Dentist | – |
| 99100 | In House Tariff – Surgical Appliances (general) | 54 | Dentist | – |
| 99113 | CPAP Apparatus/ Machine for sleep apnoea | 54 | Dentist | – |
| 99143 | Difference between Cost and NHRPL (PMB) | 54 | Dentist | – |
| 99210 | Chronic medication | 54 | Dentist | – |
| 99214 | Overseas Claims- Acute Meds | 54 | Dentist | – |
| 99342 | Repairs and maintenance of approved/ chronic | 54 | Dentist | – |
| 99443 | Polmed Administrator Liability | 54 | Dentist | – |
| 99520 | Basic dental treatment at Prov Hospital/Clinic | 54 | Dentist | – |
| 99521 | Advanced dental work at Clinics / Prov Hosp | 54 | Dentist | – |
| 99552 | Stale Claims Approved | 54 | Dentist | – |
| 99565 | Services approved from accumulated savings | 54 | Dentist | – |
| 99699 | Modifier corrections -Transmed Take on | 54 | Dentist | – |
| 99751 | Dental Implants on hospital account | 54 | Dentist | – |
| 99753 | Internal prosthesis – Total Hip Replacement | 54 | Dentist | – |
| 99900 | FOREIGN SERVICES – HOSPITAL 100% | 54 | Dentist | – |
| 99910 | Additional Claim: Dental/Samwu Ex-Gratia | 54 | Dentist | – |
| 99929 | Ex-Gratia Specialised Dentistry | 54 | Dentist | – |
| 99999 | Deposit on hospital account. | 54 | Dentist | – |
