Email: drq@vipsperio.com
P: 469.231.1155 • F: 972.695.4026

Fee Schedule

The following is a list of ADA procedure codes with the associated fee ranges.  I find that it is best for the patient to have both the exact fee for the procedure, as well as the financial arrangements made prior to scheduling any appointments with our office.  We may need to discuss these issues together to find what works best for your practice.

Code Description Fee Ranges*
D6010 Dental Implant $2000-2500.00
D7210 Extraction $300-500.00
D4263 Bone $500-800.00
D4266 Membrane $500-800.00
D7951 Sinus Life (Lateral) $2500-3000.00
D7952 Internal Sinus Lift $700-1000.00
D4260 Osseous 4+ teeth/quad $1500-2000.00
D4261 Osseous 1-3 teeth/quad $1100-1300.00
D4270 Pinhole Surgical Technique (per tooth) $600-800.00
D4273 Connective Tissue Graft (1) $1000-1400.00
D4273 Connective Tissue Graft (2-4) $2200-2800.00
D4249 Clinical Crown Lengthening (1) $1000-1100.00
D4249 Clinical Crown Lengthening (2-4) $2200-2700.00
D4210 Gingivectomy (1-3) $1000-1400.00
D4212 Gingivectomy (4+ teeth/quad) $1800-2300.00
D7960 Frenectomy $500-600.00
D4240 Gingival Flap $500-800.00
D7286 Soft Tissue Biopsy $200-300.00
D4274 Distal Wedge $600-700.00
D7291 Supracrestal Fiberotomy $500-600.00
D7280 Surgical/Access/Unerupted $500-700.00
D7261 Sinus Closure $300-500.00
D7310 Alveoloplasty (per quad)

$400-500.00

D4275 Allograft (Alloderm) $2200-2800.00